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Breast and Endocrine Surgery

BREAST AND ENDOCRINE SURGERY, INCLUDING DIAGNOSIS AND TREATMENT OF CANCER

About Our Services

St. Joseph’s Physicians Surgical Services provides compassionate, comprehensive care for breast and thyroid or parathyroid conditions, including cancer.  Generally, the first course of treatment for cancerous tumors is surgery. Depending on the outcome of the surgical procedure, other treatments, such as chemotherapy, may be recommended.

Some of the factors influencing the decision to perform surgery and the type of surgery required include:

• Type of cancer
• Size of the tumor
• Presence of multiple tumors
• Location of the tumor
• History of cancer
• Treatment history
• General health history

Should you need surgery, you will be surrounded by a team of experts in their field who are committed to your well-being and who will work in concert with other specialists and primary care providers as part of a coordinated treatment plan. 

About Our Surgeons

St. Joseph’s Physicians Surgical Services physicians have always been on the leading edge of surgical capabilities in the Syracuse area:

• Among the first surgeons in Syracuse to use robotic laparoscopic surgery and perform laparoscopic colon surgery
• Some of the first and only surgeons in our area to perform breast ultrasounds and minimally-invasive stereotactic biopsy procedures in an office setting, including mammosites

Our team of surgeons, nurse practitioners and physicians assistants, and trained breast navigators provides patients with state-of-the-art treatment options for breast or endocrine disorders. Should surgery be necessary for a cancerous condition, we specialize in breast-conserving treatments that remove only as much tissue as necessary near the tumor site. 


• Dr. Sivakumar
• Dr. Albert
• Dr. Certo
• Dr. Dentes
• Dr. Maini
• Dr. Oliva
• Dr. Stevens
• Dr. Kort
• Dr. Webb
• Mya Robertson, FNP 
• Yana Popilevskaya, PA
• Nicole Mattes, PA
• Lisa Cico, NP

Breast Cancer Facts

Approximately one in eight women will develop breast cancer in their lifetime. About 232,670 new cases of breast cancer will be diagnosed in American women in 2014 and, while more rare, over 2,000 men will be diagnosed. Breast cancer is the most common cancer among women, and the second deadliest. Fortunately, most women are diagnosed at earlier stages of breast cancer due to the use of mammography screening and regular examinations. The best time to start checking for breast cancer is when there are no symptoms—in other words, when you feel fine. When cancer is detected early, there are more treatment options available and you have a greater chance of survival. Mammography screening combined with clinical breast examinations gives you the best chance of finding cancer early and treating it. More than 80% of breast cancer patients are cancer-free at 10 years post-diagnosis.

Common Types of Breast Cancer

Ductal Carcinoma
Ductal Carcinomas come from the ducts that carry milk to the nipple. This type of cancer represents the majority of breast cancers and is usually found by an abnormal mammogram result. Occasionally, cancer will develop in the lobules of the breast where milk is made. Pathologists will examine cancer cells of a ductal carcinoma to determine whether it is confined to the duct. If so, it will be determined to be ductal carcinoma in situ (DCIS). This type of cancer has an excellent prognosis and is usually treated with surgery and, occasionally, radiation therapy.
 
Infiltrating Ductal Carcinoma
If the cancer has spread beyond the ducts, it is identified as invasive or infiltrating. This cancer is often identified via mammogram or a lump in the breast and is the most commonly diagnosed breast cancer. 

Infiltrating Lobular Cancer
Infiltrating lobular cancer has a similar prognosis to infiltrating ductal carcinoma, but presents itself differently. It is often seen as a “thickening” of the breast tissue rather than as a distinct lump. This may make it more difficult to diagnose on a mammogram or through examination. 

Inflammatory Breast Cancer
Although inflammatory breast cancer represents only one to three percent of all cancers, it is a highly aggressive form of cancer that develops very quickly. Most patients will not develop a distinct lump. Rather, the skin becomes swollen, red, heavy and warm to the touch. This is because the cancer blocks the lymph vessels in the skin. Skin may have a “pitted” appearance, like an orange peel. Symptoms may be confused with a breast infection, also called mastitis. Inflammatory breast cancer is diagnosed by skin biopsy and chemotherapy often precedes surgical treatment.

Surgical Options

Surgical treatment is the current standard of care for breast cancer. Additional treatment such as radiation or chemotherapy may be required depending upon the outcome of surgery. 

Some of the factors influencing the decision to perform surgery and the type of surgery required include:

• Type of cancer
• Size of the tumor
• Presence of multiple tumors
• Location of the tumor
• History of cancer
• Treatment history
• General health history

Where possible, our surgeons utilize breast-conserving therapy (BCT) as our primary mode of treatment. Most women with breast cancer can be treated using this approach. The portion of the breast containing the tumor is removed (lumpectomy) and the healthy tissue is left intact. Studies have shown that this approach can be as effective as a mastectomy in treating certain types of tumors. Your doctor will discuss your surgical options with you based upon your unique medical situation.

Should you and your surgeon determine a mastectomy is more appropriate for your medical condition, there are several options. First, your surgeon may recommend a modified radical mastectomy where the entire breast is removed and usually the lymph nodes in the armpit if they test positive via sentinel biopsy. In a radical mastectomy, the entire breast is removed including the chest wall muscles and lymph nodes if they test positive via sentinel biopsy. In a simple mastectomy, only the breast is removed.

One of the most common places for breast cancer to spread is the lymph nodes. A sentinel node biopsy tests the nodes where the lymph fluid drains from the breast to detect the spread of cancer.  A radioactive substance is given prior to the biopsy where it will travel to the sentinel node. During the biopsy, the surgeon will evaluate this node for the presence of cancer cells. If this test is negative, no additional nodes will need to be removed. A positive test result will necessitate the removal of additional lymph nodes to attempt to remove the cancer cells.

During your testing and treatment, you and your surgeon will discuss all treatment options available for your situation and your surgeon will recommend the treatment protocol that is most appropriate for your condition.

Risk Factors

Breast cancer can strike anyone, at any age. However, certain risk factors have been identified that make an individual more likely to develop cancer. Proper screening is, therefore, important for everyone, regardless of the presence of these risk factors. Additional screening based on your medical history may be recommended. Consult your doctor for guidance on screening and your individual risk factors.

The following are commonly accepted risk factors for breast cancer:
  • Aging – About 75% of breast cancers are diagnosed in women over the age of 50.
  • Family History of Breast Cancer – Having a first-degree relative who developed breast cancer increases your risk of developing the disease, particularly if your relative was diagnosed before the age of 50 and the cancer was located in both breasts.
  • Personal History of Breast Cancer – If you had cancer in one breast, you have a greater risk of developing a new breast cancer in the other breast or on the same side in another part of the breast.
  • Race – Caucasian women are at slightly higher risk of breast cancer than African-American women.
  • Menstrual Periods – If you started menstruating before the age of 12 or reached menopause after the age of 55, you are at a slightly higher risk for breast cancer.
  • Age at Childbirth – Women who had their first child after the age of 30 or who never had any children are at a slightly elevated risk of developing breast cancer.
  • Previous Breast Radiation – Women who were exposed to large amounts of radiation as part of treatment for diseases such as scoliosis, Hodgkin’s Disease, lymphoma or tuberculosis are at greater risk for developing breast cancer prior to the age of 30. Small amounts of radiation associated with chest x-rays or mammograms does not increase the risk of cancer.
  • Hormone Replacement Therapy – Long-term hormone replacement therapy after menopause (lasting greater than 5 years) has been shown to increase a woman’s risk for cancer. The decision to use hormone replacement therapy should be made by a woman and her doctor after evaluating the risks and benefits of the treatment.
  • Breast Lesions – Certain proliferating cells have been associated with increased cancer risk. These include Atypical Ductal Hyperplasia, Atypical Lobule Hyperplasia and Lobular Carcinoma In Situ.
  • Weight – Being overweight, especially after menopause increases your risk of developing breast cancer. 
  • Alcohol – Drinking more than one drink per day increase your risk for cancer.
  • Genetics – Five to ten percent of breast cancers are associated with a hereditary gene. The most common are BRCA1 and BRCA2. The risk for a woman carrying one of the BRCA gene mutations is as high as 50 to 85 percent. Many people with a family history of breast cancer consider genetic counseling and testing for these mutations. If you are considering this option, please consult with your physician for recommendations on qualified counselors who can advise you on the risks and benefits of these procedures.  

Thyroid Cancer Facts

Thyroid cancer is one of the fastest-growing cancers in the United States and is the most common endocrine cancer. It occurs in all age ranges and is one of the few cancers where there is an increase in the rate of occurrence. Approximately 60,000 new cases of thyroid cancer will be diagnosed each year and it is more common in women than men. About 1,850 people will die of thyroid cancer each year.

Many patients, especially in the early stages of thyroid cancer, do not experience symptoms. However, as the cancer develops, symptoms can include a lump or nodule in the front of the neck, hoarseness or difficulty speaking, swollen lymph nodes, difficulty swallowing or breathing, and pain in the throat or neck. 

Most thyroid cancers, if detected early, can be treated very well. Treatments for thyroid cancer include surgery, radioactive iodine treatment, external beam radiation therapy, and chemotherapy. In most cases, patients undergo surgery to remove most of the thyroid gland, and are treated with thyroid hormone replacement therapy.

   
 

Urgent Care Locations

St. Joseph's Physicians in Liverpool
5100 West Taft Road
Liverpool, NY 13088
315-452-2333


St. Joseph's Physicians in Fayetteville
4100 Medical Center Drive
Fayetteville, NY 13066
315-637-7800

Patient Satisfaction Hotline

315-452-2895
   
   
 
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Contact St. Joseph's Physicians

Family Medicine, Liverpool: 315.452.2828
Family Medicine, Fayetteville: 315.637.7878
Family Medicine, Radisson: 315.652.1325
Family Medicine, Heritage Group,
Fayetteville: 315.663.0059
Family Medicine, Heritage Group,
Cazenovia: 315.655.8171
Internal Medicine, Syracuse: 315.474.0542
Surgical Services, Liverpool: 315.634.3399
Surgical Services, Fayetteville: 315.632.3300