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Lumpectomy with Sentinel Node Biopsy
Questions about Lumpectomy with Sentinel Node Biopsy.
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AskedPublicly Submitted Question
11/27/2017Dear Lillie,
You see a lot of patients plus you have had breast cancer yourself.
Are most patients happy with their lumpectomy results?
Are most patients happy with their mastectomy plus reconstruction results?
What do the patientís think? I am disappointed with my lumpectomy results.
Why isnít more data out there to guide MDís and patients to make a decision? Plenty of info on surgical procedure but nothing to measure the competency of the surgeon to do the job right. It appears that surgical skills do not match the offering of treatment. No clinical trials to analyze surgical MD performance but plenty of trials to experiment on patientís. Could be a hugh money saver to our government and insurance companies. No one is evaluating the patientís post op experience and satisfaction levels. No one is measuring which MDís have better outcomes than others. Sharing best practices is important. How can we get unskilled MDís out of treating patients for cancer when a good aesthetic outcome is expected? MDís get paid whether they do a good job or not. It would also save money to have the right surgeon do the right job the first time. Training surgeons is important. What would happen if an excellent surgeon trained others on a procedure with better outcomes, better aesthetic outcomes and still get the cancer out?
RepliedJHU's Breast Center Reply
11/28/2017Most of our patients are happy with their results. We do however also see patients post treatment who had their surgery elsewhere and want us to "repair" it because the cosmetic outcome is not what was needed or desired. Lumpectomies should only be done when there is adequate breast volume to have the amount of tissue that is needed to be removed still result in the breast looking good with little or not difference from its prior appearance. If a large lumpectomy is needed and the breast volume is moderate to small, then really a skin sparing mastectomy with reconstruction should be happening instead of a lumpectomy. you are correct that its important to have a breast surgical oncologist to do the surgery and a breast reconstruction plastic surgeon. we teach doctors to become stellar breast surgical oncologists. it is something we take pride in. Research has demonstrated that high volume breast surgical oncologists have higher survival rates too. interesting discovery even though they are not making decisions about chemotherapy. consider coming to us for a "repair" and see one of our breast reconstruction surgeons. 443-997-1513

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