Breast Cancer is the most common cancer in women and surveys have shown that it is one of the most feared diseases by women of all ages. We have made a great deal of progress in recent years and Yale Cancer Center is at the leading edge of finding even better solutions for the treatment of breast cancer. Breast symptoms such as lumps, discharge, pain or abnormalities on mammograms are extremely common. Although only a small percentage of these symptoms turn out to be caused by cancer, they produce a great deal of anxiety and worry among women. For all these reasons, the Breast Center at Smilow Cancer Hospital at Yale-New Haven provides multidisciplinary, patient focused care for women diagnosed with breast cancer or other breast problems. Our Center is the only NAPBC (National Accreditation Program of Breast Centers) Accredited, National Cancer Institute designated comprehensive cancer center in the Northeast.
At the Breast Center, the emphasis is on providing coordinated simultaneous appointments with all the appropriate specialties. If a woman is being evaluated for a breast abnormality, she can often have a breast imaging study by a breast radiologist at the same time as her appointment with the breast surgeon. Similarly if she has been diagnosed with breast cancer, the breast surgeon, medical oncologist, and radiation oncologist can evaluate her during one visit. The Breast Center provides convenient appointments, rapid diagnosis and treatment, and access to the most up-to-date technology and research protocols. Most importantly, patients receive personal, friendly, confidential care that is designed to meet the needs of the whole patient, not just the disease.
Although many general surgeons do breast surgery, there is no question that dedicated breast surgeons have the experience and knowledge to handle difficult or unusual cases and are generally more likely to understand the complexities of a breast cancer diagnosis and treatment. The surgeons affiliated with the Yale Breast Center perform breast surgery exclusively.
Historically, Yale surgeons were among the first to perform lumpectomy instead of mastectomy, and today they are among the first in the nation to develop non-invasive procedures like sentinel lymph node biopsy, intraoperative guidance by ultrasound, and advanced oncoplastic procedures. Careful attention is paid to achieving the highest chance for cure while achieving the best possible cosmetic result and quality of life.
The Breast Center performs approximately 20,000 breast examinations each year. These consist of screening and diagnostic mammograms, breast ultrasounds, and magnetic resonance imaging (MRI) examinations. In addition, over 1,000 needle biopsies of the breast are performed each year. Yale was one of the first facilities in the country to perform stereotactic needle biopsies of the breast, and is one of the few facilities in the region that can perform MRI-guided needle biopsies. The radiologists who read the imaging examinations and perform needle biopsies are all specialists in breast imaging who each interpret several thousand examinations per year. Breast imaging is also available through Yale-New Haven Hospital’s mobile mammography service.
Sometimes, mastectomy is still necessary, Yale breast surgeons work hand-in-hand with plastic surgeons to offer a variety of types of breast reconstruction. Reconstructions vary from placement of a simple implant to elaborate reconstructions using natural tissue from the abdomen or back. In each case, the approach is customized to best fit the goals and lifestyle of the patient. Cosmetic surgery for patients with large or sagging breasts is also available.
Most breast cancer patients also need drug therapy, such as chemotherapy or hormonal therapy, in addition to surgery and radiation. The Yale medical oncology team consists of nationally known experts in breast cancer, and utilizes both standard approaches as well as exciting new investigational agents. New clinical trials testing novel therapeutic approaches are also available to our patients.
Investigators at Yale are famous throughout the world for elucidating the biology of a cellular receptor called HER-2. Yale Cancer Center physician researchers have been particularly successful in developing treatment strategies for HER2 positive breast cancer and are currently offering innovative therapies for all subtypes of breast cancer. In addition to treating patients here, our medical oncologists are happy to see patients for second opinions.
One of the most important elements of modern breast cancer treatment is a experienced, high-level pathology service. Yale is fortunate to have one of the finest pathology departments in the country. And, because it operates “behind the scenes” patients are frequently not aware of its importance. Today breast cancer is divided into an increasingly complex number of categories based on a whole host of sophisticated molecular markers and subtle differences that were simply not available a few years ago. Pathologists play a crucial role in the treatment planning conferences as the treatment options available for a given patient frequently change after careful review by these experts.
Treatment with radiation is an integral part of therapy for the majority of breast cancer patients today. Smilow Cancer Hospital has state-of-the-art radiation therapy facilities available to patients. It is one of the largest radiation therapy departments in the United States and serves a substantial number of patients with breast cancer each year. The department was one of the first in the United States to treat a large number of breast cancer patients following a lumpectomy with radiation therapy, and currently has one of the largest single institution databases concerning lumpectomy patients in the world.
Partial breast irradiation is also an option for certain women who benefit from targeted radiation with fewer side effects.
Patient Support Services
The Breast Center has a dedicated patient support staff to provide essential services to our patients, including nursing, social work, pastoral support, dietary and nutritional aid, physical therapy and rehabilitation, and psychosocial support.