NewYork-Presbyterian

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NewYork-Presbyterian/
Columbia University Medical Center
622 West 168th Street
New York, NY 10032
Tel: (212) 305-2500

NewYork-Presbyterian Cancer Centers have a long history of excellence in the prevention, early diagnosis, and treatment of breast cancer, the most common cancer among American women. Over the past 25 years, incredible advances have taken place in the field, many of which were pioneered by physicians at NewYork-Presbyterian Hospital. Breast surgeons here were the first in New York City to perform skin-sparing mastectomy, which helps improve the aesthetic outcome of reconstructive surgery. They were among the first in the metropolitan area to use sentinel node biopsy, which limits the number of lymph nodes that need to be removed to determine if a tumor has spread. In addition, our surgeons are among the few worldwide who perform bone marrow examination at the time of surgery to rule out micrometastatic disease.

NewYork-Presbyterian Hospital is a referral center for the most complex and challenging cases, providing patients who have either early stage or advanced breast cancer with a range of important and progressive therapeutic options. Patients who come here for care benefit from a multidisciplinary approach to diagnosis and treatment, comprehensive services, and a highly coordinated effort – from diagnosis through recovery.

Patient care is discussed at weekly conferences held at both NewYork-Presbyterian Hospital/Weill Cornell Medical Center and NewYork-Presbyterian Hospital/Columbia University Medical Center. These conferences bring together representatives of all specialties, including breast surgeons, medical and radiation oncologists, radiologists, pathologists, and specialists from the departments of genetics, nursing, and social work. The teams review individual cases that require multidisciplinary consultation and make treatment recommendations.

Diagnostic Innovations
Ductal Lavage
An exciting development in breast cancer screening at NewYork-Presbyterian Hospital is a procedure called ductal lavage, which stratifies risk among patients at high-risk for developing breast cancer. At present, tumors that begin in the milk duct are not typically discovered until they can be seen on a mammogram or sonogram. With ductal lavage, fluid is painlessly withdrawn from the milk ducts and examined by pathologists for abnormal or suspicious cells. Depending on the results of this analysis, a patient might be put on a high-risk monitoring program.

Lymph Node Dissection
The Hospital's breast surgeons were leaders in the study of sentinel lymphadenectomy, a technique that involves identification and removal of a single key lymph node under the arm to assess the potential spread of cancer beyond the breast. In addition to being less invasive than other techniques, sentinel lymph node biopsy allows surgeons to obtain information immediately while the patient is still in the operating room. In addition, complications such as swelling and numbness are virtually nonexistent with this procedure.
Bone Marrow Aspiration
Our surgeons pioneered the use of bone marrow examination at the time of breast surgery to rule out micrometastatic disease. This procedure helps to guide follow-up treatment of breast cancer patients and determine the stage of the disease. It is a minor procedure performed at the same time that the patient has breast surgery. A small amount of bone marrow is removed from each hip through tiny incisions. Pathologists then conduct a specialized analysis to determine if cancer cells are present. If they are detected, more aggressive therapy following surgery may be indicated.

Innovative Imaging Methods
Our specialists also are evaluating the use of new imaging technology, including breast magnetic resonance imaging (MRI) and ultrasound, which may change the way treatment for breast cancer is approached.

Therapeutic Excellence
Surgical Advances
NewYork-Presbyterian Hospital breast surgeons are leaders in skin-sparing mastectomy and were the first surgeons to perform areola-sparing mastectomy. This approach maintains the same skin pigmentation in the nipple area that existed prior to the surgery, and requires only a tiny incision just around the nipple and spares all the skin of the breast.

Radiation Therapy
Our Cancer Centers employ new breakthroughs in radiation therapy technology. Mammosite partial breast radiation is a new brachytherapy technique that is changing the face of breast cancer treatment. With this technique, some breast cancer patients may be able to undergo drastically shortened radiation therapy through the use of a device implanted at the time of surgery. The device radiates the area and is removed after five days, providing the patient with a full radiation regimen that otherwise would take six weeks. Other forms of intraoperative radiation therapy, including photon beam electron radiation therapy and intensity modulated radiation therapy (IMRT), are under development here as well. As members of the Radiation Therapy Oncology Group, the Cancer Centers will remain at the leading edge of new therapies in this area.

Chemotherapy
Patients with advanced breast cancer or aggressive or recurring disease often are candidates for clinical studies of new therapeutic agents. NewYork-Presbyterian Cancer Centers are involved in several promising trials, including examinations of targeted therapies, combination therapies, and hormonal therapies.

Ablative Treatment
NewYork-Presbyterian Hospital is the only center in New York City performing ablative treatment the use of heat, cold, or lasers to destroy tumors for breast cancer. Using a technique similar to stereotactic biopsy, ablative treatment is performed under local anesthesia through a tiny hollow probe about the size of a toothpick. The probe is inserted into the tumor and wires are deployed to heat the tumor until it is destroyed. The procedure is very safe when used for small tumors that are not too close to the skin or muscle tissue.

Prevention Advances
NewYork-Presbyterian Cancer Centers provide a comprehensive range of secondary prevention and early detection programs for breast cancer. Both medical centers offer mammography, clinical breast exams, chemoprevention studies, enhanced surveillance programs, as well as genetic testing and counseling. To learn more about the specific programs offered at NewYork-Presbyterian Hospital, please call 1-877-NYP-WELL.

@New York Presbyterian Hospital