Once you have been told
That you have breast cancer or might have breast cancer, you will be referred to a surgeon. There are many doctors who perform breast cancer surgery, but most do not specialize in breast cancer. They may just do a handful of cases a year.
We recommend that you choose a breast surgeon who:
- Specializes in breast cancer – This demonstrates a commitment and expertise in treating this disease; breast surgeons will be more up to date on the latest surgical techniques than general surgeons who may not focus entirely on breast cancer surgery)
- Has done a breast surgical oncology fellowship
- Is recognized as a breast surgical oncologist
- Performs many breast cancer surgeries each year – High volume surgeons tend to have better results and are more attuned to subtle differences in individual cases. Research shows that patients of breast surgeons who perform a very large volume of breast cancer surgeries have a higher survival rate than patients of lower-volume surgeons. Seek out a physician who does 50 or more breast cancer operations a year, and preferably more than 100. It is important to mention that these are breast cancer surgeries (lumpectomies and mastectomies), not breast surgeries. Only breast cancer treatments should be counted in these numbers—not excisional biopsies.
At the Johns Hopkins Avon Foundation Breast Center, our breast surgeons are experts in breast surgical oncology. They work closely with our plastic and reconstructive surgeons to give women the best cosmetic results and options.
Our specialists have a greater than 90 percent rate of performing successful breast conservation surgery for patients who meet the criteria for a lumpectomy—which saves a woman’s breast(s) and gives her an equal survival rate when compared to women who chose a mastectomy.
We also offer nipple-sparing and skin-sparing mastectomy for patients who meet specific pathology criteria.
State-of-the-Art Surgery with Minimal Pain and Nausea
Our breast surgical oncologists and anesthesiologists have pioneered improvements in surgical and anesthesia management along with other post-surgical care to minimize nausea and vomiting rates for breast cancer patients. The nausea rate at some breast centers is as high as 85 percent. We have reduced our nausea rate to 1 percent for patients having lumpectomy or mastectomy without simultaneous reconstruction or lumpectomy surgery. This fosters a quicker recovery; the majority of our patients who have breast cancer surgery without reconstruction feel so physically well after the surgery that they choose to go home that same day.
Patients and their family members are instructed in post-treatment wound care. There are special circumstances when arrangements are made for a home health care nurse to visit the patient’s home that evening and the next morning, although this is rarely needed. A nurse practitioner from the Breast Center is in constant contact with the patient for updates.
It is the patient’s decision about whether to return home the day of surgery. If she does, her pain will be well controlled with oral medications so she’s nausea-free and able to concentrate on her emotional well-being. Any time a patient can avoid hospitalization, the risk of infection is reduced and faster healing is possible. She can also return to normal daily activities sooner.
Women having lumpectomy surgery may be ready to go home after being in the recovery room for one to two hours. We have studied how well our patients feel post-operatively and more than 50 percent feel well enough to go out to lunch or dinner that evening to celebrate completing the treatment. This is a testament that they are nausea-free and ready to embrace life again.