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School of Medicine
The Breast Cancer Road to Recovery
Innovations in breast surgery and reconstruction over the past decade have greatly improved the outcomes available to women. New techniques decrease the appearance of scars and provide a more natural appearance. Learn more about what to expect during breast cancer staging and surgical treatment, as well as the variety of reconstruction options.
Breast Cancer Staging
Sentinal Node Biopsy
Every breast biopsy is precisely targeted to disrupt only the suspicious breast tissue, leaving the rest of the breast intact. In fact, 90 percent of breast biopsies can be obtained in a minimally-invasive manner without an incision or general anesthesia.
Your physician will recommend the most minimally-invasive procedure possible depending on the size and location of your mass. Having an expert opinion about the type and grade of cancer will affect your treatment from the very beginning.
Breast Cancer Surgery
Mastectomy is the removal of the breast, including the nipple and areola. At Johns Hopkins, the skin sparing mastectomy is the most common type of mastectomy surgery performed for breast cancer treatment. Your physician will guide you in deciding which mastectomy to have, but as always, you should be an active part of any decisions that directly affect your treatment.
Breast Cancer Reconstruction
Breast Reconstruction Overview
Women with breast cancer have two main considerations when considering reconstructive breast surgery—when to have surgery and what type of surgery to have. All of the options below are available to patients who are good candidates and healthy enough for surgery.
A common breast reconstruction technique is tissue expansion, which involves expansion of the breast skin and muscle using a temporary tissue expander. A few months later, the expander is removed and the patient receives either microvascular flap reconstruction, or the insertion of a permanent breast implant. This type of breast reconstruction requires two separate operations.
The superior gluteal artery perforator (SGAP) flap uses tissue from the top of the buttocks to create breast tissue. This is usually done if patients do not have adequate skin and tissue in their abdomens, or have had previous abdominal surgeries that may have interfered with blood vessels that the DIEP flap requires.
The DIEP flap is the technique where skin and tissue (no muscle) is taken from the abdomen in order to recreate the breast. This is the most common procedure performed at our Breast Center as women generally have excess skin and fat along the lower portion of their abdomen; plus, patients like the “tummy tuck” it gives.
A breast implant is a silicone shell filled with either silicone gel or a salt-water solution known as saline. This is a good option for women who do not require radiation therapy for their breast cancer treatment. It also may be easier to control the final size of the breast with implant reconstruction in some cases.
A woman may opt for delayed reconstruction if a plastic surgeon was not involved after her mastectomy. Many women did not know their breast reconstruction options at the time of mastectomy. More and more they’re discovering that surgically recreating their breasts is possible and is required to be covered by insurance as a result of a federal law passed in 1998.
Some revisions after breast reconstruction surgery can help improve shape and symmetry. Talk to your doctor about how to make your breasts look and feel as natural as possible.