AHN Breast Surgery Division

Types of breast cancer surgery

We work with you to tailor your comprehensive treatment plan. Breast cancer surgery is usually recommended to remove the cancer in your breast. Lymph nodes may also be evaluated to see if your cancer has spread. Our breast cancer surgeons may collaborate with a plastic surgeon to help preserve the appearance of your breasts.

Breast-conserving surgeries

• (Localized) lumpectomy: Also known as a partial mastectomy, this surgery involves removing an area of your breast tissue. A magnetic seed, radioactive seed, or wire localization device is used to help find non-palpable breast cancer and creates a targeted surgical approach.
• Oncoplastic breast surgery: Oncoplastic techniques may be used by a breast surgeon to rearrange your breast tissue to close a lumpectomy defect or by working in combination with a plastic surgeon to preserve the appearance of your breast.

Mastectomies

• Mastectomy: All your breast tissue is removed, including the nipple areola complex and much of your breast skin, leaving a flat closure without reconstruction.
• Skin-sparing mastectomy: Your nipple and areola are removed, but much of your breast skin is available for breast reconstructive surgery.
• Nipple-sparing mastectomy: Your breast tissue is removed but your nipple, areola, and most of your breast skin is kept intact. A plastic surgeon can fill this space with a breast implant, tissue expander, or tissue from another part of your body.
• Nerve-preserving mastectomy: A breast cancer surgeon and plastic surgeon will create a plan for the re-sensation of your breast skin and/or nipple area. During the surgery, the breast surgeon will identify sensory nerves that the plastic surgeon will use for grafting.
• Modified radical mastectomy: Your entire breast — including your nipple, areola, and skin — and the majority of your axillary lymph nodes are removed with axillary lymph node dissection.

Axillary lymph node surgeries

These breast cancer surgeries are used to remove the lymph nodes found in your armpit.

• Sentinel lymph node biopsy: A dye is injected into your breast and travels to the first draining lymph nodes in your armpit area to see if the cancer has spread. The dye will help target any lymph nodes where cancer is present, avoiding more extensive breast cancer surgery. The dye may be a blue dye, radioactive dye, magnetic dye, or a combination.
• Delayed sentinel lymph node biopsy: A special magnetic dye is injected into your breast for patients with noninvasive breast cancer (ductal carcinoma in situ). The dye travels to the first draining lymph nodes and remains in the lymph nodes for 30 days. If final pathology of your breast tissue shows any evidence of invasive cancer, a delayed sentinel node biopsy can be performed.
• Axillary reverse mapping: Blue dye is injected into the tissue of your upper inner arm, is taken up by your lymphatic channels, and then travels to your armpit (axilla). Your lymphatics and nodes, which get stained blue, are those draining from the arm. If the blue-stained nodes are not also the sentinel nodes from the breast, they may be preserved to decrease the risk of arm lymphedema.
• Targeted axillary lymph node dissection: A limited number of targeted and sentinel lymph nodes are removed in patients who become node negative after receiving chemotherapy for node positive breast cancer.

Breast reconstruction surgery

Our plastic surgeons are skilled at different breast reconstruction surgeries performed during or following breast cancer surgery.

• Tissue expander and implant reconstruction surgery: With tissue expander reconstruction, temporary empty implants are placed within the mastectomy cavity and slowly inflated with saline or air over time. This helps stretch your skin to create more space for implants. Patients who choose to have breast reconstructive surgery at the same time as their mastectomy (immediate reconstruction) may need tissue expanders if the doctor decides the skin needs more time to heal. After some months, the expanders will be replaced with either an implant or tissue flap reconstruction. Some patients are candidates for direct implants in a single stage without requiring tissue expansion first.
• Tissue flap reconstruction surgery: Your plastic surgeon will use tissue from another part of your body to restore shape and volume to your breasts. This technique can be performed during a mastectomy operation or at a later date.

Breast cancer surgeons

At AHN, all of our breast cancer surgeons are board-certified in general surgery, and many have also received the highest level of training in specialty areas, including breast surgical oncology (breast cancer surgery). Their focused training ensures you are in skilled, trusted hands.

Breast cancer surgery appointments

If you need to make an appointment for breast cancer surgery, we're here to help.

Need to make an appointment?

Call (412) 578-HOPE (412) 578-4673 to schedule an appointment at the Allegheny Health Network Cancer Institute, or request a call.

Surgery and additional treatments

If you require other treatments in addition to surgery at the Cancer Institute, such as chemotherapy and/or radiation, you can receive all of your care at AHN. Or you can choose to receive the additional treatments at another facility closer to your home. Your navigation team can assist to make the process seamless.

Schedule a mammogram

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What to expect

The care journey for each patient can look different, but a nurse navigator will help you every step of the way. From coordinating appointments, to helping you manage side effects, to working on nutritional and financial issues, they’ll guide you and your family through the process.

Breast cancer clinical trials and research

AHN specialists lead the NSABP Foundation, the world’s preeminent breast cancer research program. It’s one of the largest focusing on breast cancer clinical trials.

What is a clinical trial?

Clinical trials are studies that try to answer questions about new ways to treat cancer with medications, radiation, or surgical techniques. Previous trials have shown how new methods of treatment improve survival and quality of life and reduce the risk of cancer returning.

Who can join a clinical trial?

You need to meet certain criteria to participate in a clinical trial, and you only take part in it if you want to. Also, you can stop participating in a trial at any time.

The plan for the trial, called a protocol, explains the goal of the trial and how the study will be conducted. Based on the questions the research is trying to answer, each clinical trial protocol specifies the type of patient who can join the trial.

Common criteria for entering a trial are:

• Having a certain type or stage of cancer.
• Having received a certain kind of therapy in the past.
• Being in a certain age group. 

Federal rules help ensure that clinical trials are run in an ethical manner, with your rights and safety protected. These rules ensure that you’re not put at increased risk by participating in the trial, and that the results of the study are accurate and meaningful.

Currently active breast cancer clinical trials

If you would like to participate in a clinical trial and help our innovative team discover groundbreaking cancer solutions, ask your doctor if you are eligible. See which clinical trials are currently active and open for participation.

Refer your patient to an AHN Cancer Institute specialist

There are three ways for medical professionals, who are not a part of Allegheny Health Network, to refer their patients to an AHN Cancer Institute specialist and request their first appointment. You can:

1. Call (412) 578-HOPE (412) 578-4673 to speak with an AHN Cancer Institute scheduling coordinator.
2. Go to Find Care to find the right AHN specialist and the most convenient location. Then refer your patient, provide relevant patient details, and request an appointment directly from the doctor's profile.
3. Use AHN Physician Access to refer your patient to an AHN Cancer Institute specialist and request an appointment.

For more information about referring your patient to an AHN specialist, read the Independent Physician Referral FAQs.

Follow your patient's health care at AHN with EpicCare^® Link™

After referring your patient to an AHN specialist, use the EpicCare Link platform to collaborate with their AHN specialist, view your patient's test results, treatment plan, and progress.

Log in to your EpicCare Link account now.

If you are new to EpicCare Link, or need to request your own EpicCare Link account, read: EpicCare Link for Patient Follow-up, for user instructions and new account request forms.

When EpicCare Link is not an option for patient's AHN medical records

If you can’t access your patient's AHN test results through the EpicCare Link platform, your patient will need to complete and submit the correct AHN Medical Records Release form, based on their state of residency. Support your patient’s request by downloading the correct medical records release form for them:

• AHN Medical Records Release Form for New York state residents
• AHN Medical Records Release Form for all other patients