Breast cancer affects one in eight women throughout their lives, yet not every hospital in the nation has dedicated breast surgeons. At the Department of Surgery at Montefiore Medical Center, Chairman Robert E. Michler, MD, and Vice Chairman Steven K. Libutti, MD, are committed to hiring the finest subspecialty surgeons who work in a multidisciplinary fashion to personalize treatment for each individual patient. Their mission brought Leslie Montgomery, MD, Chief, Division of Breast Surgery and Lisa Wiechmann, MD, Attending Breast Surgeon, to the Department to treat patients with benign and malignant breast disease.
"Dr. Montgomery is an internationally recognized expert in all breast diseases and an innovative researcher," Dr. Michler remarks. "She has more than 11 years experience and is sought out by patients from all across the country."
In addition to its high level of expertise, advanced therapies and multidisciplinary team, the Division of Breast Surgery is also known for its exceptional patient education. "Patients are a fundamental part of the team. It is vitally important that they are educated about their disease so they can make the best treatment decisions with our guidance". "We explain the process and each step involved in the treatment," notes Dr. Wiechmann. "We always reinforce the fact that in most cases, breast cancer is curable. We aim for no less and focus on the cure, working as a team."
Advanced Breast Surgery
The multidisciplinary team at the Montefiore-Einstein Center for Cancer Care (MECCC) is comprised of: medical oncologists, surgical oncologists, radiation oncologists, plastic and reconstructive surgeons, social workers, geneticists, pathologists, radiologists, patient navigators, psychologists and a specialist in lymphedema. When patients come to appointments, they meet with various members of their specialized team.
The ultimate goal for each patient is to come up with a personalized plan that considers both the optimal cancer care and the expectations and desires of each patient.
The surgeons in the Division of Breast Surgery at Montefiore offer a variety of surgical approaches to breast cancer patients. Factors that are considered important during surgical treatment planning include tumor size, location, breast size, and patient preference. Based on these and other factors, patients will be offered one or more of the following options:
- Lumpectomy (breast-conserving surgery): removing only the cancerous tissue with a surrounding rim of normal tissue. This operation requires post-operative radiation therapy.
- Mastectomy: the removal of all breast tissue
- Skin-sparing mastectomy: the removal of all breast tissue with preservation of the skin of the breast, but not the nipple and areola.
- Nipple-sparing mastectomy: the removal of all breast tissue preserving the skin of the breast, the nipple, and areola. This operation is only offered in very selected cases.
- Modified radical mastectomy: the removal of all breast tissue and the underarm lymph nodes, which have been affected by cancer.
Underarm (Axillary) Lymph Nodes
- Sentinel lymph node biopsy: the mapping, removal, and microscopic examination of the sentinel nodes, which are the first lymph nodes to receive cancer cells from breast tumors.
- Axillary lymph node dissection: The removal of the axillary lymph nodes when cancer has spread to those lymph nodes.
- Oncoplastic surgery: The objective of oncoplastic surgery is to combine complete tumor resection with optimal cosmetic outcome in the setting of breast conserving surgery (lumpectomy). Oncoplastic surgery is considered an integral part of "personalized surgery" and underscores the need to tailor surgery to each individual patient and breast cancer.
- Post-mastectomy breast reconstruction:
- Autologous tissue reconstruction: This technique uses muscle and fat derived from the patients' body (usually from the back or the stomach) to re-create the shape of the breast.
- Tissue expander and implant reconstruction: This technique uses tissue expanders followed by saline or silicone implants to re-create the shape of the breast.
Our Commitment to Exceptional Care
The team at the Montefiore-Einstein Center for Cancer Care strongly believes that coordinated care at a dedicated cancer center, supported by a backbone of active research studies, is essential for patient success. Drs. Montgomery and Wiechmann are developing an outstanding breast cancer program at Montefiore that couples exceptional clinical care through a multidisciplinary approach with the highest level of research.
MECCC initiates various research studies and participates in many of the national trials currently in progress. Our oncologists discuss eligibility with each of our patients to optimize their treatment at Montefiore. All of our research endeavors have the common goal of improving patients' quality of life and overall survivorship.