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School of Medicine
Breast Surgical Oncology
Choose a Surgeon Who Specializes in the Breast
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 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. 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 the nausea and vomiting rate for breast cancer patients. The nausea rate at some breast centers has been as high as 85 percent. We have reduced our nausea rate to 1-2 percent for patients having lumpectomy or mastectomy without simultaneous reconstruction. This fosters a quicker recovery; the majority of our patients who have breast cancer surgery without reconstruction feel so physically well after 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 nurse to visit the patient’s home that evening and the next morning, although this is rarely needed. A registered nurse or nurse practitioner from the Breast Center is in constant contact with the patient for updates. Her pain will be well controlled with oral medications and she is usually nausea-free and able to concentrate on her emotional well-being. Any time a patient can avoid hospitalization, risk of infection is reduced and faster healing is possible. She can also return to normal daily activities sooner.
Learn About Breast Surgical Procedures
- Axillary node dissection
- Sentinel node biopsy
- Lumpectomy/breast conservation
- Oncoplastic surgery
- Simultaneous reconstruction
- Staged reconstruction
- Preventive/prophylactic mastectomy