Our breast imaging 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. We were one of the first facilities in the country to perform stereotactic needle biopsies of the breast; and are one of the few facilities in the region that can perform MRI guided needle biopsies. The radiologists who interpret 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 our mobile mammography service and at Long Wharf in New Haven.
In addition, the Breast Center now performs 3-D mammography, also known as digital breast tomosynthesis. This new technology allows the radiologist to view the breast in thin "slices" rather than as a whole and should improve detection of lesions and will also reduce false alarms due to overlapping normal tissues. Currently, our technologists use the new 3-D technology along with standard imaging. This combination provides the radiologist an opportunity to compare the familiar standard images with prior mammograms. The 3-D imaging is performed simultaneously with the mammogram so the length of the exam does not change. While tomosynthesis involves a small increase in the radiation dose, the total radiation dose remains below the federal standards for mammography.
When it comes to breast surgery, there is no question that dedicated breast surgeons have the experience and knowledge to handle difficult or unusual cases and generally are more likely to understand the complexities of diagnosis and breast cancer treatment. The surgeons affiliated with the Breast Cancer Program perform breast surgery exclusively. Historically, breast surgeons affiliated with Yale New Haven Hospital were among the first to perform lumpectomy instead of mastectomy, and today they are among the first in the nation to develop non-invasive breast surgery 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 after breast surgery.
Reconstructive Breast Surgery
When mastectomy is part of the treatment plan, our breast surgeons work hand-in-hand with plastic surgeons to offer a variety of types of breast reconstruction. Breast surgery reconstructions can 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 breast 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. Medical oncology at Smilow Cancer Hospital consists of nationally known experts in breast cancer, and utilizes both standard approaches as well as exciting new investigational agents. There are also exciting clinical trials testing novel therapeutic approaches. In addition to treating patients, our medical oncologists are happy to see patients for second opinions and will collaborate with community oncologists who may be closer to a patient's home.
Because it operates "behind the scenes," most patients are not aware of pathology services. Yet a high-level pathology service, such as the one that exists at Smilow Cancer Hospital, is one of the most important elements of modern breast cancer treatment. Today breast cancer is divided into an increasingly complex number of categories based on a whole host of sophisticated molecular markers, special stains and subtle differences that were simply not available a few years ago. Pathologists play a crucial role in the breast cancer treatment planning conferences as the treatment options available for a given patient frequently change after careful review by these experts.
Breast Cancer Treatment with radiation is an integral part of therapy for the majority of patients today. Smilow Cancer Hospital's state-of-the-art radiation therapy services 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 with lumpectomy and radiation therapy, and currently has one of the largest single institution databases concerning lumpectomy patients in the world. A clinical study into the use of partial breast irradiation is currently underway enabling women to benefit from targeted radiation with fewer side effects.
Breast Cancer Support Services
Patient support staff provide essential services such as social work, pastoral support, nutritional advice, physical therapy and rehabilitation. Most important, patients receive personal, friendly, confidential care designed to meet the needs of the whole patient, not just the disease.
Learn more about the Yale Breast Cancer Program and its cutting-edge research
Learn about Cancer Genetic Counseling at Smilow Cancer Hospital