Breast Surgery Services at Montclair Breast Center, Montclair, New Jersey

Montclair Breast Center Breast Surgeons: Marcie Hertz, MD FACS, Nancy Elliott, MD FACS, Director of Montclair Breast Center, and Dana Holwitt, MD.

When surgery is necessary, our patients have the safety and convenience of using our fully accredited ambulatory surgery center located on the lower level. At Montclair Breast Center most surgery is performed as an out-patient procedure including excisional breast biopsies, lumpectomies and sentinel lymph node surgery. [See full list of Montclair Breast Center's diagnostic and therapeutic services below.]

Convenience and private care are great advantages, particularly when image-guided biopsies are required. Our breast imagers are able to localize mammographic abnormalities upstairs in the digital mammography suite and then simply send you downstairs for your surgical procedure. Our exceptional board-certified anesthesiologist always meets with you prior to your surgery to answer all your questions. Newer anesthetics eliminate the nausea and grogginess that used to accompany surgery, so patients feel well after the procedure and go home 1-2 hours after surgery. Minimally invasive techniques create substantially less pain and our patients take only Tylenol (acetaminophen) or nothing for surgical discomfort. Your surgeon is always available to speak with you and your family afterwards because her office is in the building. This facilitates communication, enhancing the doctor-patient relationship. Recovery is fast and an appointment is made for pathology review within 2 days.

The addition of on-site same day surgery completes the full array of breast diagnostic and treatment modalities making Montclair Breast Center a unique private breast hospital.

When reconstructive surgery is needed, Montclair Breast Center works with several plastic surgeons in the community and we are happy to provide recommendations.

Overview of Breast Surgery Services at Montclair Breast Center, Montclair, New Jersey

At Montclair Breast Center we offer breast cancer screening, breast cancer treatment and follow up care for patients with benign and malignant breast issues. Our breast surgeons have specialty training in breast surgical oncology and offer the highest degree of expertise in the field. We work very closely with our specialty breast imagers in our Center, as well as medical and radiation oncologists, plastic surgeons, oncology nurse navigators and psycho-social support practitioners to provide a multidisciplinary team approach to breast cancer care.

We also offer high risk surveillance and management for women and families at high risk for the development of breast cancer.

Diagnostic and Therapeutic Procedures available at Montclair Breast Center

Fine Needle Aspiration Biopsy A very thin needle is used to draw fluid or cells from a lump.Slides are made and sent to the pathologist for evaluation. Fine needle aspiration biopsy is often used to differentiate solid from cystic abnormalities in the breast It can be done with or without ultrasound guidance If an abnormality is cystic, aspiration biopsy may be therapeutic in completely resolving the cyst No anesthesia is necessary
Ultrasound Guided Core Biopsy Ultrasound is used to guide a needle into an abnormality. Several cylindrical cores of tissue are removed. Pathologists evaluate the tissue and can tell us if the abnormality is cancer or a benign process. Core biopsy is done with local anesthesia in the office.
Technetium Injection for Sentinel Lymph Node Identification Injection of radiolabeled dye around the areola on the breast with known cancer. The dye is taken up the lymphatic channels in the breast and is carried to the first few lymph nodes that drain the breast in the axilla. A gamma probe (pictured above) is used to identify the lymph nodes that have taken up the most dye. If there is no cancer in the sentinel lymph node, no further lymph nodes are taken. If there are cancer cells identified in the sentinel lymph node, then additional axillary lymph nodes are removed (axillary lymph node dissection).
Surgical Excisional Biopsy Outpatient, same day surgery procedure. A small piece of abnormal tissue is removed surgically to aid in diagnosis of breast abnormalities. Can be done with local anesthesia with or without sedation in our private ambulatory surgical center in our building. Excisional biopsy is rarely performed as a primary diagnostic procedure as most breast abnormalities are amenable to minimally invasive needle biopsies In certain situations, excisional biopsy is required for primary diagnostic purposes for abnormalities that cannot be accessed via minimally invasive needle techniques; ie: the abnormality is too far back near the chest wall; the breast is too small to accommodate the needle required for biopsy
Lumpectomy (partial mastectomy, breast conserving surgery, wide local excision of breast cancer) Removal of a known breast cancer with a rim of normal tissue around it. Outpatient, same day surgery procedure. Can be done with local anesthesia with or without sedation in our private ambulatory surgical center in our building.
Oncoplastic Reduction Breast Conserving surgery done in combination with a reduction procedure. Combined operation with a plastic surgeon. The procedure allows larger tumors to be removed with lumpectomy, that would otherwise require mastectomy. Appropriate candidates for oncoplastic reduction are determined by your breast surgeon and a plastic surgeon.
Traditional Mastectomy: Removal of the nipple, areola (the dark part around the nipple) the majority of the breast skin and the breast tissue leaving a smooth flat chest wall. Usually done under general anesthesia. In selected patients, it can be done as an outpatient procedure in our private ambulatory surgical center in our building or in the hospital. Some patients require an overnight hospitalization.
Skin Sparing Mastectomy: Removal of the nipple, areola , a small amount of breast skin and the breast tissue. Breast skin is saved for women who desire reconstruction by the plastic surgeon. Usually done under general anesthesia. In selected patients, it can be done as an outpatient procedure in our private ambulatory surgical center in our building or in the hospital. Some patients require an overnight hospitalization depending on the type of reconstruction they choose.
Nipple sparing Mastectomy: Removal of the breast tissue with conservation of the nipple areolar complex For highly selected patients, such as women who carry a mutation in BRCA 1 or 2, women with small tumors more than 4 cm away from the nipple. Usually done under general anesthesia In selected patients, it can be done as an outpatient procedure in our private ambulatory surgical center in our building or in the hospital Some patients require an overnight hospitalization depending on the type of reconstruction they choose

Fine Needle Aspiration Biopsy

A very thin needle is used to draw fluid or cells from a lump.Slides are made and sent to the pathologist for evaluation.

Fine needle aspiration biopsy is often used to differentiate solid from cystic abnormalities in the breast

It can be done with or without ultrasound guidance

If an abnormality is cystic, aspiration biopsy may be therapeutic in completely resolving the cyst

No anesthesia is necessary

Ultrasound Guided Core Biopsy

Ultrasound is used to guide a needle into an abnormality.

Several cylindrical cores of tissue are removed.

Pathologists evaluate the tissue and can tell us if the abnormality is cancer or a benign process.

Core biopsy is done with local anesthesia in the office.

Technetium Injection for Sentinel Lymph Node Identification

Injection of radiolabeled dye around the areola on the breast with known cancer.

The dye is taken up the lymphatic channels in the breast and is carried to the first few lymph nodes that drain the breast in the axilla.

A gamma probe (pictured above) is used to identify the lymph nodes that have taken up the most dye.

If there is no cancer in the sentinel lymph node, no further lymph nodes are taken.

If there are cancer cells identified in the sentinel lymph node, then additional axillary lymph nodes are removed (axillary lymph node dissection).

Surgical Excisional Biopsy

Outpatient, same day surgery procedure.

A small piece of abnormal tissue is removed surgically to aid in diagnosis of breast abnormalities.

Can be done with local anesthesia with or without sedation in our private ambulatory surgical center in our building.

Excisional biopsy is rarely performed as a primary diagnostic procedure as most breast abnormalities are amenable to minimally invasive needle biopsies

In certain situations, excisional biopsy is required for primary diagnostic purposes for abnormalities that cannot be accessed via minimally invasive needle techniques; ie: the abnormality is too far back near the chest wall; the breast is too small to accommodate the needle required for biopsy

Lumpectomy (partial mastectomy, breast conserving surgery, wide local excision of breast cancer)

Removal of a known breast cancer with a rim of normal tissue around it.
Outpatient, same day surgery procedure.

Can be done with local anesthesia with or without sedation in our private ambulatory surgical center in our building.

Oncoplastic Reduction

Breast Conserving surgery done in combination with a reduction procedure.

Combined operation with a plastic surgeon.

The procedure allows larger tumors to be removed with lumpectomy, that would otherwise require mastectomy.

Appropriate candidates for oncoplastic reduction are determined by your breast surgeon and a plastic surgeon.

Traditional Mastectomy:

Removal of the nipple, areola (the dark part around the nipple) the majority of the breast skin and the breast tissue leaving a smooth flat chest wall.

Usually done under general anesthesia.

In selected patients, it can be done as an outpatient procedure in our private ambulatory surgical center in our building or in the hospital.

Some patients require an overnight hospitalization.

Skin Sparing Mastectomy:

Removal of the nipple, areola , a small amount of breast skin and the breast tissue.

Breast skin is saved for women who desire reconstruction by the plastic surgeon.

Usually done under general anesthesia.

In selected patients, it can be done as an outpatient procedure in our private ambulatory surgical center in our building or in the hospital.

Some patients require an overnight hospitalization depending on the type of reconstruction they choose.

Nipple sparing Mastectomy:

Removal of the breast tissue with conservation of the nipple areolar complex

For highly selected patients, such as women who carry a mutation in BRCA 1 or 2, women with small tumors more than 4 cm away from the nipple.

Usually done under general anesthesia

In selected patients, it can be done as an outpatient procedure in our private ambulatory surgical center in our building or in the hospital

Some patients require an overnight hospitalization depending on the type of reconstruction they choose

Articles of interest:

Wall Street Journal, 1 July 2008
New Surgery Eases the Toll of Breast Cancer

Breast Cancer; MRI before surgery leads to better-adapted treatment for breast cancer
Clinical Oncology Week, 28 April 2008