The diagnosis and treatment of breast masses remains a core part of the care we provide at Florida Surgical Clinic. We aim to diagnose and treat breast disease and leave patients at ease. Almost every patient is understandably concerned after he or she suspects a breast mass. The first step in determining treatment is a full history and physical exam. The importance of a good history cannot be overstated as it is imperative to determining a patient’s risk for cancer and potentially prognosis.
After a full history and physical a diagnostic mammogram or ultrasound is ordered if it was not previously completed. Depending on the findings, patients may require a fine needle aspiration (FNA), stereotactic biopsy, core needle biopsy, or open biopsy.
- Fine Needle Aspiration– A fine needle aspiration uses a small needle to aspirate the tissue of concern. Often this is used for fluid filled lesions under direct visualization with an ultrasound. This procedure of often performed in the office. Patients require only local anesthesia and can immediately return to work and daily activities. The fluid removed is separated from any cells floating in the fluid. These are analyzed for possible cancerous cells. Depending on the results, patients may require further biopsy, treatment or nothing at all.
- Stereotactic Biopsy- A stereotactic biopsy uses a mammography machine to determine the exact area to biopsy. This is usually used for small calcifications seen on a mammogram. The tissue is taken in a circle around the point of interest and usually a radiographic clip is placed to mark the biopsy site. The tissue is sent to pathology for testing. Patients require only local anesthesia and can immediately return to work and daily activities. Depending on the results, patients may require further biopsy, treatment or nothing at all.
- Core Needle Breast Biopsy– A core needle biopsy uses a larger needle to take a sample of tissue. This method can be used with palpable masses or for masses seen under ultrasound. Often these are performed in the office. Patients require only local anesthesia and can return to work and daily activities immediately after. Depending on the results, patients may require further biopsy, treatment or nothing at all.
- Open Breast Biopsy – An open biopsy requires the surgeon to make a small incision and remove the area of concern. The entirety of the concerning tissue need not be taken at this time if a change in diagnosis will change the course of treatment. Alternatively, if the area of small, it is taken out entirely. This is easily done for palpable lesions. However, if the lesion is only seen radiographically, it can be marked with a wire by radiology prior to the procedure. The tissue is removed and sent to pathology. This is performed using local and IV anesthesia. These procedures are usually performed in the out patient setting. Patients go home the following day and can return to normal activities in 24-48 hours.
- Lumpectomy- A lumpectomy removes the tissue surrounding a cancerous mass. Often, patients are able to go home the same day. The incision is usually small and removes a small quadrant of the breast tissue. The tissue is sent to pathology to confirm complete removal of the cancer.
- Mastectomy– A mastectomy removes the breast tissue in its entirety. This is most often done for cancerous masses. Depending on the status of the lymph nodes, patients may require a sentinel node biopsy or axillary lymph node dissection. Patients usually stay at least overnight in the hospital. Patients can return back to work and normal activities when they no longer require narcotic pain medication and can easily use his or her arm. The ability to perform an immediate reconstruction needs to be discussed with the surgeon, oncologist, and plastic surgeon to determine the safest, most ideal plan.
Dr. Jenna Kazil is a magnificent Bradenton-based double board-certified general and vascular surgeon with tremendous experience with a wide variety of breast procedures. She is a great general and vascular surgical specialist who is affiliated with various hospitals on the West coast of Florida in Hillsborough, Manatee and Sarasota counties. Dr. Jenna Kazil is a kind and compassionate surgeon who understands a patient’s perspective and emotional needs while enduring a breast procedure from diagnosis to recovery. Dr. Kazil is also the only practicing double board-certified female vascular and general surgeon in Hillsborough, Pinellas, Manatee, and Sarasota counties. Anyone requiring a breast procedure should contact the Florida Surgical Clinic for their surgical needs.