Breast Cancer Care | Department of Surgery | Washington University in St. Louis

Washington University surgeons provide the highest level of care for people with breast cancer. As leaders in the field, Washington University surgical oncologists and plastic and reconstructive surgeons partner with Siteman Cancer Center to treat over one thousand new breast cancer patients each year.

Breast cancer is a disease in which abnormal breast cells grow rapidly and invade healthy cells in the body. It is the second most common cancer among women in the United States, and also the second leading cause of cancer death in women. About 1 in 8 U.S. women will develop invasive breast cancer over the course of her lifetime.

Risk factors for breast cancer include age, genetics, family history, reproductive history, diet and lifestyle. A mammogram is most the common tool used to screen for breast cancer. At the Joanne Knight Breast Health Center, most women receive regular screening mammograms as part of a routine checkup. If a lump is discovered through mammography and/or ultrasound testing, breast surgeons often are able to perform a biopsy the same day. Should a patient be diagnosed with breast cancer, she will be able to develop a treatment plan by meeting with several physicians, including a cancer surgeon, a plastic and reconstructive surgeon, a medical oncologist and a radiation oncologist.

Washington University Physicians understand that no two breast cancer cases are alike. Washington University breast cancer surgeons provide advanced, personalized and professional care at one of the country’s top-ranked cancer centers.

“Since I started my practice in 2006, there have been some amazing advances that I’ve witnessed,” says surgical oncologist Julie Margenthaler, MD. “I think patients who come in who have a personal experience with breast cancer or knew somebody that was treated for breast cancer in the past can be reassured that their experience is going to be very different because we now have targeted therapies, advanced surgical procedures and amazing reconstructive options.”

Surgery to remove the cancer and a rim of normal breast tissue surrounding it is the primary treatment for breast cancer. Typically, breast surgery is performed first. Then, if needed, chemotherapy and radiation therapy follow.

The type of surgery performed depends upon the patient’s preference, the size and location of the breast lump and/or the type and stage of the breast cancer, the size of the breast and genetic testing results.

Types of breast surgery include:

Lumpectomy

A procedure to remove the tumor (or lump) from the breast. The surgeon cuts out the tumor as well as a layer of surrounding tissue to ensure that no cancer cells are left behind. Lymph nodes are often removed as well so they can be examined for signs of cancer.

Lumpectomy with breast reduction

For women with large breasts, the surgical oncology and plastic surgery team can perform a breast size reduction. They start on the breast with cancer, removing the lump and the cancer-free tissue that surrounds it. Then, the other breast is reduced to match.

Mastectomy

A procedure to remove the entire cancerous breast. Sometimes, patients with especially aggressive cancers or other high-risk factors will choose to have both breasts removed. This procedure is called a bilateral mastectomy.

Skin and nipple-sparing mastectomy

This procedure preserves the nipple and as much of the skin as possible. Though the procedure is only appropriate in patients whose tumors are not too close to the nipple or whose breasts are not too large, it makes reconstruction much easier when it can be done.

Breast reconstruction surgery

Breast reconstruction is the recreation of all or part of a breast which has been surgically removed. A plastic and reconstructive surgeon may create the new breast using an implant or tissue taken from another part of the body. New medical techniques and devices have made it possible for plastic surgeons to reconstruct a breast close in form and appearance to a natural breast.

For some women, breast reconstruction surgery is part of the treatment plan from the beginning. Reconstruction of the breast following a lumpectomy or mastectomy is just as unique as the personalized plan to eradicate breast cancer. Because surgical oncologists and plastic surgeons work so closely together, many women are able to choose the timing of their reconstruction surgery.

“A multidisciplinary team approach to breast cancer care is always important because it enables myself to work closely with the general surgeon to make sure that we are able to tailor a breast reconstruction plan for each one our patients,” says plastic and reconstructive surgeon Terence Myckatyn, MD. “It’s important to go to a center where the breast cancer surgeon and the reconstructive surgeons work together on a daily basis to ensure that the most appropriate procedure both for the mastectomy and the reconstruction is chosen.”

Washington University Physicians can provide screening, care options and treatments for breast cancer. Surgeons see patients at Barnes-Jewish Hospital, Barnes-Jewish West County Hospital, Barnes-Jewish St. Peters Hospital, the Center for Advanced Medicine, Alton Memorial Hospital* and Siteman Cancer Center.

Katherine Glover-Collins, MD, PhD, a fellowship-trained breast surgeon with research experience in genetic mutations linked to breast cancer, sees patients at Christian Hospital. Many women in North County are diagnosed with late-stage breast cancers due to health disparities in their community. She is addressing these disparities by promoting mammography screening, access to funds for underinsured women and comprehensive cancer care.

To make an appointment with a Washington University breast cancer surgeon, please call (314) 747-7222. To make an appointment with a plastic and reconstructive surgeon, call (314) 362-7388.

Washington University Breast Cancer Specialists:

Surgical Oncology