Surgeons from Pottstown Memorial Cancer Center are now performing a skin-sparing mastectomy procedure that removes cancerous tissue through an incision around the nipple area rather than cutting across the entire breast. The surgery not only promises less scarring, it has proven to be as effective as a simple mastectomy.

Maneesh Ailawadi, M.D., a surgical oncologist, works in tandem with Ben Eskra, M.D., a plastic surgeon, giving breast cancer patients the most natural-looking breast possible, often making a diagnosis of breast cancer easier to bear. Dr. Eskra consults with the cancer surgeon to mark where the incisions should be made for the best cosmetic outcome. After Dr. Ailawadi removes the cancerous breast tissue, leaving most of the overlying skin, Dr. Eskra places a tissue expander behind the chest wall muscle and partially fills the expander with saline in preparation for placing an implant during another procedure.

"We’ve come a long way in breast cancer treatment," explains Dr. Ailawadi. “It used to be that surgery required the entire breast area to be surgically removed. “Now more skin is left so that patients have more choices.”

He added that the skin sparing mastectomy has been performed for over a decade at university centers, but is now offered to patients at very select community hospitals. “Patients at Pottstown Memorial Regional Cancer Center have many more options than ever before, and it is right in their own neighborhood. They no longer have to go to the large city hospitals for the latest procedures.”

Dr. Eskra said that the benefits are an immediate reconstruction with a breast mound. “Women wake up from surgery with an aesthetically appealing breast, which is certainly very different from seeing a flat chest wall with minimal tissue. It is a psychological and aesthetic benefit. It should be considered in every patient who is a being evaluated for breast cancer surgery.”

Billie Jean Buckland, 34, and a resident of Reading, was diagnosed with Ductal Cancer In Situ (DCIS), a cancer in the milk ducts of the breast. It can grow to cover a small or large area of the breast, but it has not yet spread outside the duct into the normal surrounding breast tissue, to the lymph nodes, or to other organs. After conferring with Dr. Ailawadi, Buckland decided to have the skin sparing mastectomy.

“I am young, have a husband and children, and want to live life to the fullest with them,” said Buckland. “I decided to have the skin sparing mastectomy so that I could begin the reconstruction process immediately. I spent only three days in the hospital and the doctors caring for me were fabulous. They are my guardian angels.”

Buckland underwent a combined procedure with Dr. Ailawadi performing the skin-sparing mastectomy, followed immediately during the same operation, by Dr. Eskra performing the initial stage of her reconstruction, which involved placement of a bilateral breast tissue expander. A tissue expander needs to be placed first to expand the space behind the muscle of the chest wall and provide a place for the implant to go. The expansion is the process of injecting saline into the expander on a weekly or bi-weekly basis after the placement of the expander, in order to fill it and create the space for the implant. This usually takes a month to four months to complete.

“The extra skin remaining after a skin-sparing mastectomy is highly advantageous for the reconstructive surgery,” said Dr. Eskra. “I am able to fill the tissue expander much more at the time of the operation, sometimes even completely. When she wakes up with a larger, more breast-shaped mound, she is happier, it eases the psychological burden, and makes me feel good because I was able to do more.”

“I am happy with the outcome of my first surgery and am looking forward to the implant procedure,” Buckland remarked. “I feel good about myself and the way I look.”

Dr. Ailawadi added that breast reconstruction can dramatically improve a woman's appearance, self-confidence and overall quality of life. “It is important that the plastic surgeon, along with the surgical oncologist and patient, determine the right course of treatment for the patient.”

Pottstown Memorial Regional Cancer Center’s (PMRCC) breast services include stereotactic breast biopsy, mammotome biopsy, breast MRI, sentinel lymph node dissection, lymphedema services, and breast IMRT. PMRCC’s Breast Health Coordinator assists each woman to ensure they receive guidance, referral to appropriate specialist, education and support in a timely manner. Pottstown Memorial Regional Cancer Center is a Fox Chase Cancer Center Partner and offers a multidisciplinary approach to cancer care.

For more information on the Pottstown Memorial Regional Cancer Center, call (610) 327-7555, or check out the link from our home page.