General InformationBreast cancer is the most common cancer in women and surveys have shown that it is one of the most feared diseases by women of all ages. A great deal of progress has been made in recent years and Yale Cancer Center is at the leading edge of finding even better solutions. Breast symptoms such as lumps, discharge, pain or abnormalities on mammograms are extremely common. Although only a small percentage of these symptoms turn out to be caused by cancer, they produce a great deal of anxiety and worry among women. For all these reasons, the Yale Breast Cancer Program provides multidisciplinary, patient-focused care to women diagnosed with breast cancer or other breast problems.
When women are facing a possibly life-threatening condition, they want the most expert care possible. At the Breast Center, the emphasis is on providing coordinated simultaneous appointments with all the appropriate specialties. If a woman is being evaluated for a breast abnormality, she can often have a breast imaging study by a breast radiologist at the same time as her appointment with the breast surgeon. Similarly, if she has breast cancer, she can be evaluated by the breast surgeon, medical oncologist, and radiation oncologist during the same visit to the multidisciplinary breast cancer clinic. The Yale Breast Cancer Program provides convenient appointments, rapid diagnosis and treatment and access to the most up-to-date technology and research protocols. Most importantly, patients receive personal, friendly, confidential care that is designed to meet the needs of the whole patient, not just treat the disease.
Although many general surgeons do 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 breast diagnosis and treatment. The surgeons affiliated with the Yale Breast Cancer Program perform breast surgery exclusively. Historically, Yale surgeons were among the first to perform lumpectomy instead of mastectomy, and today, they are among the first in the nation to develop non-invasive 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.
The 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. Yale was one of the first facilities in the country to perform stereotactic needle biopsies of the breast, and is 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 a satellite facility on Long Wharf in New Haven.
When mastectomy is still necessary, Yale breast surgeons work hand-in-hand with plastic surgeons to offer a variety of types of breast reconstruction. Reconstructions 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 surgery for patients with large or sagging breasts is also available.
Most patients need drug therapy, such as chemotherapy or hormonal therapy, in addition to surgery and radiation. Medical oncology at Yale Cancer Center 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 here, Yale Cancer Center 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.
Investigators at Yale are famous throughout the world for elucidating the biology of a cellular receptor called HER-2. Medical oncologists at the Yale Cancer Center have been particularly successful in developing treatment strategies for HER2 positive breast cancer and are currently offering innovative therapies for all subtypes of breast cancer. In addition to treating patients here, Yale Cancer Center medical oncologists are happy to see patients for second opinions.
One of the most important elements of modern breast cancer treatment is a high-level pathology service. Yale is fortunate to have one of the finest pathology departments in the country. And, because it operates "behind the scenes," patients are frequently not aware of its importance. 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 treatment planning conferences, as the treatment options available for a given patient frequently change after careful review by these experts.
Treatment with radiation is an integral part of therapy for the majority of breast cancer patients today. Smilow Cancer Hospital has state-of-the-art radiation therapy facilities. Yale radiation oncologists were one of the first groups to begin treating breast cancer patients with lumpectomy and radiation therapy, and currently have access to one of the largest databases of lumpectomy patients in the world. The radiation oncologists at Yale are continually seeking out the best methods for the delivery of radiation therapy to our patients, including partial breast irradiation.
Patient Support Services
The Yale Breast Cancer Program treats the "whole" person, not just the disease. The patient support staff provides essential services such as nursing, social work, pastoral support, dietary and nutritional aid, physical therapy and rehabilitation and psychosocial support.
Services offered by the Breast Center include:
- Breast Imaging
- Breast Surgery
- Genetic Counseling
- Medical Oncology
- Patient Support Services
- Radiation Oncology
- Reconstructive Surgery