Breast Cancer Treatment

Conveniently located to serve the areas of Dallas, North Dallas, Southlake and the mid-cities.

Breast Conservation Therapy

Lumpectomy removal of the cancer tissue alone, leaving residual unaffected breast tissue. Can be done alone or with simultaneous oncoplastic reduction; scar pattern can be modified to facilitate cancer excision.

  • Benefits
    1. Can facilitate cancer removal with increased surgical access for breast surgeon
    2. Maintain symmetry
    3. Typically maintain sensation to breast and nipple
    4. Single-stage, outpatient procedure
  • Limitations
    1. Some cancers not amenable to lumpectomy
    2. Will require radiation therapy
    3. Will require continued mammograms for surveillance

Mastectomy

This requires removal of all the breast tissue typically including the nipple as well. If a mastectomy is decided upon or required, reconstruction is an option for the patient. Reconstruction can be done as a unilateral or bilateral procedure

  • Benefits
    1. Eliminate the need for radiation therapy in most patients
    2. No longer require mammograms for surveillance
  • Limitations
    1. More invasive procedure, losing sensation to the breast and nipple
    2. If breast reconstruction after mastectomy is desired, it may require multiple staged procedure

 

Oncoplastic Reduction

Coordinated surgery between the breast surgeon and plastic surgeon, to facilitate cancer removal and do a simultaneous breast reduction and lift.

Location and size of cancer will dictate the scar location and size, the degree of reduction, and lift.

Oncoplastic Reduction Illustration

 

Breast Reconstruction After Mastectomy

** Goal of reconstruction is to maintain a degree of size/shape symmetry and proportionality to the rest of the body

** Timing and type of reconstruction can typically be combined in any scenario depending on the patient desires, type of cancer and patient’s treatment regimen

Timing

  1. Immediate – initiated at the time of the mastectomy
    • more commonly desired by the patient
  2. Delayed- initiated after the patient has completed cancer treatment
    • Reasons to delay reconstruction
      • Oncologist treatment plan, most prominently need for radiation therapy even after mastectomy
      • Other medical risk factors: obesity, diabetes, smoking, radiation
      • Access your risks now: Brascore.org
      • Psychological state of the patient

Type

  1. Implant-based – typically a two stage procedure; a temporary tissue expander (spacer) is placed at the time of mastectomy with immediate reconstruction, volume is slowly added to the tissue expander in the office and once the desired volume is reached a second surgical procedure is performed to exchange the tissue expander for a permanent implant
    • Benefits
      • Relative short surgical procedure with a slightly shorter recovery
      • No additional scars
    • Limitations
      • Aging process of implant reconstructed breast, more pronounced with a unilateral procedure
      • Requires patient comfort with implant and implant long term maintenance
    Implant-Based Reconstruction
  2. Autologous-based – utilizing the patient’s own tissue from another part of the body to reconstruct the breast, abdomen is currently most commonly used donor site, other options include thigh, buttock or back
    • Benefits
      • Ages more naturally than an implant, responding to weight gain/loss
      • No implant maintenance
    • Limitations
      • Slightly longer surgical procedure with longer recovery process and hospital stay
      • Additional scars required
    Autologous-Based Reconstruction

Recent modifications with surgical cancer treatment, which can impact reconstructive options:

  • Nipple-sparing mastectomy
  • Single stage direct to implant
  • Pre-pectoral implant reconstruction

Nipple Reconstruction

Nipple reconstruction can be done surgically or with tattooing; most people today are opting for 3D nipple tattooing.

Nipple Reconstruction

If you are considering a breast cancer reconstruction in SouthLake Texas contact Dr Habash for a consultation today.

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