Breast Disease and Cancer
We offer a holistic approach to breast health at our state of the
art Ashikari Breast Center.
Mammography has been responsible for finding smaller and smaller
breast cancers and therefore is responsible for improving breast
cancer survival rates. At the Ashikari Breast Center we use mammopads for
a softer more comfortable mammogram experience. We also use state
of the art Ultrasonography and Breast
Magnetic Resonance Imaging (MRI) for
our high risk patients.
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When abnormalities are detected and a biopsy is necessary we
make every attempt to use techniques that provide an accurate
diagnosis while being minimally invasive. Lumps that are
felt can be biopsied by hand held core biopsy, and those found
by ultrasound need an ultrasound
guided biopsy.
Those abnormalities that are seen only on mammogram can be biopsied
using mammography using a stereotactic core biopsy technique.
Occasionally, these techniques are not possible and a surgical
biopsy is necessary.
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We see an average of over 6,000 breast patients
each year and perform over 250 breast cancer operations every
year. When cancer is detected we make every attempt to preserve
our patient’s
breasts, and are successful in over two thirds of the time. When
combined with radiation therapy, breast preservation or lumpectomy is
as effective as mastectomy or
whole breast removal. Our rates of recurrence after such
therapy is approximately 4% which is at least 50% lower than
the published national averages of 8-14%. When mastectomy is
chosen we support immediate breast reconstruction and
are affiliatated with some of the best
plastic surgeons in Westchester County who have been working
with us for over 20 years.
One of the most important pieces of information to determine stage
and treatment, is the presence of lymph node tumor metastasis or
spread. We use sentinel
lymph node biopsy to determine if our patients have lymph
node metastasis, sparing over 70% of patients more extensive
surgery.
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Breast cancer patients who have lumpectomy and in
some circumstances those who undergo mastectomy will require radiation
therapy. This can be accomplished by external
beam radiation at a location close to your home. For those
who qualify partial breast
radiation using
the Mammosite catheter
device can shrink the treatment time from 6-7 weeks to 5 days.
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Patients with strong family histories of breast cancer are
evaluated for risk of genetic abnormalities with our genetic
counselors and evaluated using careful surveillance, mammography,
ultrasound, and MRI.
Prophylactic nipple sparing subcutaneous mastectomy is currently
being offered to our high risk patients, especially those positive
for BRCA 1/2 gene mutations. We have pioneered the procedure in
the United States in close coordination with our plastic surgeons,
allowing for an immediate single-staged reconstruction. This procedure
gives patients the best cosmetic outcome while significantly reducing
breast cancer risk.
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Colorectal Cancer
We work with medical and radiation oncologists in a team approach
to maximize cure and sphincter preservation rates with standard
or laparoscopic surgical approaches. Utilizing advanced staging
techniques of PET directed surgery and Intra-operative Ultrasound,
we determine which are patients would benefit from sophisticated
treatment of metastases or recurrence, including radiofrequency
ablation and intrahepatic arterial infusion of chemotherapy.
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Endocrine Surgery
In no other field does experience translate into such better outcomes
and less complications than endocrine surgery. Our surgeons are
experienced in advanced minimally invasive parathyroidectomy and
the diagnosis and treatment of complex thyroid and adrenal tumors.
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Melanoma
Our surgeons have advanced training and extensive experience with
melanomas. We utilize sentinel lymph node biopsy techniques with
lymphatic mapping, and PET/CT scanning for the most accurate staging.
Staging is of important now that curative treatment have become
available. We practice an aggressive surgical strategy to insure
our patients have the greatest chance at cure.
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Upper Gastrointestinal Tumors
(Esophageal/Gastric/Pancreatic
Cancer)
Our surgeons are experienced with complex tumors that have been
rejected by general surgeons as too difficult or unresectable.
Through advanced techniques and the use of chemotherapy before
surgery we maximize our ability to surgically remove these tumors
for cure.
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Sarcomas (tumors of the soft tissue ie. fat, muscle, connective
tissue, blood vessels)
Our surgeons have extensive experience with these uncommon tumors.
We work closely with medical and radiation oncologists in a team
approach to improve resection and cure rates while limiting complications
and recurrence.
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