The Breast Health Clinic offers the latest advances in the diagnosis and treatment of breast diseases in a caring and efficient environment. The philosophy of the Clinic is to manage diagnostic workup effectively and expeditiously in the office. When hospital procedures are required, the least invasive, most efficacious surgical approach to the individual patient's condition is recommended.
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Clinical Breast Evaluations & Consults
Breast MRI Availability
Follow-Up of Breast Cancer & Coordination of Care
Full Field Digital Mammography
Accredited by the ACR (American College of Radiology), we perform screening and diagnostic mammography for patients with known or presumed breast problems. Mammograms are submitted to CAD (computer advanced detection). All mammograms are reviewed by our professional staff and are officially interpreted by Our certified mammographer.
Our practice is Accredited by the ASBS (American Society of Breast Surgeons). Ultrasound of the breast is a non-invasive, imaging modality, complementary to the physical examination of the breast and to the mammogram.
Image-Guided Percutaneous Biopsies
Ultrasound guided percutaneous needle aspirations and tissue core biopsies are routinely performed in the comfort of our office facility. Several diverse biopsy techniques are utilized, based on the individual circumstance. The latest vacuum assisted devices allow us to obtain more accurate tissue samples. With these newer techniques, we can completely remove small benign lesions which otherwise would have required an open surgical biopsy in the operating room.
Stereotactic X-Ray Guided Percutaneous Core Biopsy
Stereotactic X-Ray Guided Percutaneous Core Biopsy Lesions that are identified by mammography can be biopsied efficiently by various non-surgical techniques utilizing stereotactic x-ray guidance. This procedure is very accurate and is more precise than open surgical biopsy. Stereotactic x-ray guidance has been provided to our patients since 1994 and is performed in our office using the latest state-of-the-art, vacuum-assisted core biopsy methods. We have been very successful using this technique and our patients who have undergone this procedure have expressed a high degree of satisfaction. The procedure avoids surgery and does not require the services, inconveniences, and expense of the hospital venue. Stereotactic x-ray guidance is performed with a minimal amount of local anesthetic and generally does not cause discomfort. With this procedure, patients do not require post-procedure care or medication and may immediately return to performing daily activities.
Minimally-invasive surgical removal of breast lesions, when feasible, is performed in our office surgical procedure room.
High Risk Patient Management
Counseling and surveillance is provided to patients that are at higher risk for developing breast cancer due to factors such as family history or previous biopsy findings. Evaluation and testing for high familial genetic related risk is available at our clinic.
Risk reduction chemoprevention with selective estrogen receptor modulators (SERM) is routinely discussed and offered to our patients.
Selective cannulation, sampling of secreting milk ducts in order to obtain cells for cytology, and mammographic contrast imaging of suspicious secreting ducts.
The Clinic participates in local and national trials evaluating and comparing newly developed treatment modalities. Dr. Auda has been a long-time active proponent of enrolling patients in clinical trials. His work at the National Cancer Institute involved treating patients on trial protocols. In order to advance the knowledge and treatment of cancer, it is necessary to prospectively evaluate new treatment modalities, which is best achieved by enrollment in nationally sponsored clinical trials. While participation is voluntary, when feasible, it is encouraged. The majority of our patients that have participated in clinical trials have been very pleased with their experience, realizing the potential benefit to themselves and to future patients who will follow in their footsteps.
Evaluation & Relative Counseling on Tumor Specific Genes
Testing tumor specific genes and calculating a relative genetic risk score for possible recurrence, when indicated, can be obtained on biopsy or surgical specimens.
Open Surgical Breast Biopsies
When percutaneous biopsies are not possible, we perform open surgical biopsies usually in the hospital operating room. We strive to remove the minimal amount of tissue necessary for an adequate diagnostic evaluation of the involved site. Operative mammographic and ultrasound guidance are frequently used in order to preserve as much breast as possible to maintain the natural contour of the breast.
Breast Preserving Procedures
Our commitment to minimally invasive surgery extends to the treatment of breast cancer. If it is at all possible, we recommend breast conservation surgery. This surgery is performed by using various operating techniques that adequately remove the cancer, but preserve as much breast tissue as possible. Oncoplasty techniques are used when larger portions of the breast require removal.
Sentinel Node Staging
Sentinel Node Staging is an alternative surgical approach to traditional complete axillary dissection. This technique was developed in the early 90's and shortly thereafter implemented in our practice. This procedure allows us to adequately evaluate and stage the axilla without the need to perform an extensive removal of the axillary contents, unless cancer cells are found in the sentinel nodes. The advantage of sentinel node staging is to limit the extent of surgery in this delicate anatomical site, which greatly decreases the possibilities of complications to the arm and shoulder that can result from complete axillary lymphatic dissection.
Mammosite Placement for Radiotherapy
Accelerated Partial Breast Irradiation is now being selectively considered as an alternative to entire breast irradiation. This technique was developed and approved in 2002. Since its inception, the Clinic has been offering this alternative to our patients in concordance with the evaluation of the radiotherapists. We participated in the early evaluation of this technique by enrolling all our patients in a national registry. We are now in the process of participating in a national trial sponsored by the National Surgical Adjuvant Breast Project and the American Society of Breast Surgeons.
Extensive Oncologic Resections
Fortunately, these extensive surgical procedures performed to control advanced local disease and recurrences are now rarely required. Our extensive surgical oncology background allows us to address and treat patients referred with such complex problems.
Vascular Access Surgery (Port Placement)
Frequently, at the request of the treating medical oncologist, we are asked to place a long-term access device into the vascular system for the administration of chemotherapy. This procedure is performed as a day surgery in the operating room. Generally, this procedure is performed with local anesthesia aided by monitored sedation administered by the anesthesiologist.
Mastectomy with/without Reconstruction
We prefer to recommend breast conserving surgery; however, such procedures are not always possible or feasible. In such cases, total mastectomy is necessary. We have, throughout the years, modified our surgical techniques of total mastectomy in order to better improve our results. We work with the plastic surgeons to refine and to improve breast reconstruction techniques. When possible, we adopt a skin sparing mastectomy procedure, which significantly improves the cosmetic outcomes.