The Arizona Breast Clinic is dedicated to the prevention, screening diagnosis and medical treatment of breast cancer. Below are some of the surgical services and procedures we offer our patients. We have also provided some valuable questions and answers on this webpage. If you are diagnosed with breast cancer, Dr. Borjeson's goal is to rid your body of as much cancer as possible and prevent the disease from coming back.
Yes. Dr. Borjeson will carefully answer all of your questions. We are independently owned and offer a patient first approach to your breast heath needs. She may suggest more than one type of treatment.
A Mammotome Biopsy is vacuum-assisted breast biopsy using mammogram, ultrasound and/or MRI devices to help our team. A Mammotome Biopsy can be performed as an outpatient procedure with a local anesthetic.
A sentinel lymph node is the first node or nodes in the armpit that receive the lymphatic drainage from the breast. If cancer exists in the breast, it might escape to the armpit lymph nodes via these breast lymphatics. Therefore, whenever women have an operation for invasive breast cancer, surgeons routinely check the armpit to see if cancer has spread to the lymph nodes. This is called a sentinel lymph node biopsy.
Identification of the sentinel lymph node(s) is accomplished by injecting blue dye, radioactive tracer, or both, into the breast prior to lumpectomy or mastectomy. The dye and/or tracer then travel into the armpit, and turn an average of two nodes bright blue, or radioactive when using tracer. These get removed via a small incision in the armpit and are thoroughly tested by a pathologist. This analysis will reveal whether or not cancer has spread from the breast to the lymph nodes. If cancer has not spread, the nodes are "negative", indicating early stage breast cancer. If cancer has spread to the nodes, the nodes are called “positive”, and additional treatments must be considered: further surgery, radiation, and chemotherapy. In response to an exciting discovery published in 2011 by Dr. Armando Giuliano, et.al., many surgeons no longer remove additional armpit lymph nodes even after cancer is found in the sentinel nodes. We now recommend only radiating the remaining nodes in patients with 1-2 positive lymph nodes. There is a 15 year survival benefit of performing an ALND in patients with 3-5 positive sentinel nodes. Prior to the era of sentinel lymph node biopsy, surgeons would remove all of the armpit lymph nodes to make sure the cancer did not spread. This procedure, called a complete axillary node dissection, resulted in complications in up to 84% of patients, including pain, numbness, arm swelling (lymphedema), fluid buildup (seroma), limited arm movement, and infection. A sentinel lymph node biopsy can reduce these complications to under 10%.
Radiation therapy is administered to many breast-cancer patients following a lumpectomy. The goal is to reduce the risk of cancer recurrence by destroying any cancer cells in the tumor cavity. Traditionally whole-breast irradiation uses a radiation source outside the body to treat the cancer site, usually involving daily treatments for six days per week over a six- to seven-week period. Many breast cancer patients are appropriate candidates for an alternative to whole-breast radiation treatment known as partial-breast irradiation. Breast brachytherapy is a partial-breast irradiation technique that delivers radiation to tissue surrounding the lumpectomy cavity rather than to the entire breast. By targeting treatment from inside the breast, radiation treatment can be completed in five days, allowing patients to return more quickly to their day-to-day.
The common form of breast brachytherapy consists of implanting a small, balloon-like catheter device into the lumpectomy cavity several days after surgery. A radiation seed is placed inside the balloon through a catheter by a computer-controlled machine twice a day for five days of treatment. Because the balloon is placed inside the lumpectomy cavity, radiation is targeted to the "ring" of breast tissues surrounding the lumpectomy cavity.
A pathology report reveals the results of your breast cancer biopsy. This is one of the most important documents you will receive during your diagnosis. It contains a complete profile of the cancer's aggressiveness. From the results in the pathology report, Dr. Borjeson will make suggestions about what treatments will be best in order to hopefully cure your cancer. When you receive your breast cancer pathology report, you will probably feel a little overwhelmed as it contains a lot of information, and some of it may be difficult to interpret. Dr. Borjeson will help things appear much clearer.
A hormone receptor status test tells you whether or not breast cancer cells contain estrogen or progesterone receptor cells. The presence or absence of hormone receptors greatly affects your treatment options. Being positive for estrogen and progesterone receptors means you have a less aggressive cancer.