Breast Surgery and Pathology

Stamford Health breast surgeons have extensive experience in the evaluation and care of those with or are at high risk for breast disease, benign or malignant. All of our breast surgeons are fellowship trained and committed to utilizing the most modern techniques to ensure the best outcome possible.

The American Society of Breast Surgeons has issued the following statement about breast surgery fellowship training:

"The development of comprehensive breast centers has allowed for multimodality therapy in the evaluation and treatment of breast disease, including cancer. Within the multidisciplinary breast care team, the surgeon has emerged as an integral member of the team. A special kind of surgeon is needed to meet the emotional needs of the breast cancer patient, as well as a desire to master the technical skills required to perform the highest quality surgery."

Breast Surgery

Conditions Our Breast Surgeons Treat:

Benign Breast Disease

Fibrocystic breast changes, nipple discharge, mastitis, abnormal breast imaging, benign breast masses

Breast Cancer

Today, there are many options for treating breast cancer. If you need breast cancer surgery, our surgeons will work with you to review the options of breast conservation (keeping the breast intact) versus mastectomy (removing all of the breast tissue). Our surgeons are available for consultations five days a week and in the event a problem is identified, appointments can be made to see a surgeon within 24-36 hours.

Types of Breast Surgery

Breast Conserving Procedures

  • Lumpectomy or Partial Mastectomy: Removal of cancer tissue and a rim of healthy surrounding tissue

Breast Removal Procedures

  • Total (or simple) mastectomy: Removal of entire breast
  • Modified radical mastectomy: Removal of breast and lymph nodes
  • Radical mastectomy: Removal of breast, lymph nodes and chest wall muscles
  • Nipple and skin sparing mastectomy: Removal of the breast while saving the nipple and chest wall skin
  • Prophylactic mastectomy: Removal of one or both breasts. Sometimes performed for very high-risk women as a preventative measure

Lymph Node Procedures

  • Sentinel Lymph Node Biopsy: Removal of select armpit lymph nodes to test to see if the cancer has spread
  • Axillary Lymph Node Dissection: Removal of the vast majority of armpit lymph nodes, usually done because the cancer has spread

Lymphedema Surgery

  • Lymphedema Surgery: There's a strong connection between breast cancer surgery and lymphedema as breast cancer can often spread to surrounding lymph nodes

Breast Reconstruction Procedures
If you undergo a mastectomy, you may want to have immediate breast reconstruction. Our team of breast surgeons works closely with the breast cancer team to provide you with reconstructive options.

Second Opinion Program
If you’ve been diagnosed with breast cancer at another hospital, it’s normal to often want to obtain an objective and comprehensive evaluation of your treatment options. Our team of breast surgeons, radiologists and pathologists, in cooperation with medical and radiation oncologists at the Bennett Cancer Center, is available to help identify and prioritize these options.

Breast Pathology

About Breast Pathology

Our Department of Pathology plays an important role in shaping treatment plans for breast cancer patients, including advanced analysis of biopsies. Every breast cancer diagnosis is reviewed at our dedicated weekly breast cancer conference, where experienced and dedicated Breast Pathologists present their findings and give detail of the cancers to Breast Surgeons, Radiation Oncologists, Medical Oncologists, and Geneticist. In addition, every negative biopsy performed at Stamford Hospital is reviewed weekly at a Radiology-Pathology Correlation Conference to make sure no cancers are missed and that patients receive the best follow up. This is unique in the state of CT. Such formal Radiology-Pathology core correlation conferences only take place at high functioning academic medical centers and national cancer centers.

Pathology Services Offered:

Fine Needle Aspiration Biopsy Service. At Stamford Hospital, only experienced breast radiologists perform Fine Needle Aspirations because it is Radiologists, and NOT Pathologists who are most expert in using breast ultrasound. At SH, all FNAs are performed under Ultrasound Guidance to assure lesion sampling and minimize injury. Our fellowship trained, sub-specialty boarded cytopathologists evaluate these samples with expertise. Stamford Hospital is the only hospital in CT with 2 MD Anderson Cancer Center fellowship trained Cytopathologists. Results are available within 24 hours.

Tumor Markers
Breast cancer predictive testing is performed at SH using most current and validated methods. We test for Estrogen receptors, Progesterone receptors, Her2 Neu status and proliferation rate using Immunohistochemistry and quantitative image analysis to obtain the most accurate and reproducible results. We are one of very few institutions in CT to offer this advanced analysis. In addition, we evaluate tumors for Her2Neu gene amplification using Fluorescent In-Situ Hybridization (FISH) to make sure every patient has the chance to benefit from appropriate Her2 targeted drug therapy. We extensively use immunohistochemistry to "prove" our diagnosis and avoid false negative and false positive diagnoses of breast cancer. Accuracy is of prime importance to us.

Consultation Services
Our dedicated breast pathologists routinely provide second opinion evaluations to patients diagnosed with breast cancer or breast abnormalities who seek care at Stamford Hospital. Our breast Pathologists work closely with Breast Imagers/Radiologists, Breast surgeons, Radiation Oncologists and Medical Oncologists to ensure that decisions that are best for the individual patient are made. Second opinion reviews are completed within 24 hours of outside slide receipt.

Intraoperative Services
Our Breast Pathologists assist the surgeons in intraoperative evaluation of lymph nodes and margins, and in intraoperative decision making. This is done with frozen sections and margin touch prep assessment in cases requiring such attention. This service ensures that excisions are complete at time of surgery, and that return to the operating room for additional surgery is minimized.

Post Surgery Specimen Evaluation
At SH, because of excellent Surgeon to Pathologist communication, all breast excisions are carefully oriented, marked, and surgical margin assessment is optimized. This gives confidence that the tumors are adequately excised with negative margins.