General Surgeons Play Big Role in Breast Cancer

Gary Lehr, MD
Medical Director of Surgical Cancer Services at Broward Health North Broward Medical Center

In our era of micro-management and super specialization, it is a common perception amongst many people that a “super” specialist needs to be involved with patient care when certain problems arise. This is frequently evident when a woman hears the words “you have breast cancer.” The management of a woman with breast cancer almost ALWAYS involves the participation of a surgeon, as well as medical oncologists and radiation oncologists. Some feel that a specialized “breast surgeon” or “surgical oncologist” is necessary for thorough care. However, although somewhat of a misnomer, General Surgeons are a highly trained group of surgical specialists with a wide range of knowledge and expertise, including the comprehensive management of patients with breast cancer. General Surgeons become quite familiar with all aspects of breast cancer care during their five/six year surgical residency. Breast cancer is one of the most common malignancies encountered in private practice by General Surgeons, particularly in South Florida.

General Surgeons usually become involved early on in the management process, either when a lump is discovered, or a mammogram or ultrasound has been determined to be abnormal. Initial biopsy, if indicated, can be done by the General Surgeon. Once a definitive diagnosis of breast cancer has been confirmed, surgical management by the General Surgeon is tailored to the specific patient’s individual circumstances. Options usually exist regarding the extent of resection of the tumor itself, depending on the size of the cancer, location in the breast, and size of the breast. Lumpectomy (removal of the tumor with a small margin of normal tissue), partial mastectomy (removal of a more generous portion of breast tissue, but still leaving the majority of the breast intact), and total mastectomy (removal of the entire breast) may all be viable options. If the cancer has been classified as “invasive”, then sentinel lymph node biopsy is also accomplished at the same surgical setting. This involves locating, and then removing, the first few lymph nodes, usually in the axilla (armpit), that drain the breast. If these are found to be normal on microscopic evaluation, then the rest of the lymph nodes should be normal as well, eliminating the need for a more extensive resection. This, in turn, reduces the likelihood of arm swelling (lymphedema) following surgery.

Subsequent care with medical oncologists or radiation oncologists depends on the eventual staging of the cancer. Sometimes, surgery is all that is required. The General Surgeon is quite familiar with the total care of a woman with breast cancer, and can make recommendations regarding the need for further care. In our practice, we have taken care of countless patients with both benign and malignant breast problems, and take pride in the thoroughness and comprehensive management we give to each patient.

Gary S. Lehr, M.D., FACS, Randy Kimmelman, D.O., Michael Mallis Jr., D.O., Camil Sader, M.D., FACS, and Ron Stricoff, M.D., FACS, are all Board Certified General Surgeons, with years of experience in the management of breast cancer.

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