Breast Center: Services

Advanced Digital Imaging

2-D and 3-D Mammography: For women with an average risk of breast cancer Automated Whole Breast Ultrasound: For added clarity necessary with dense breast tissue Molecular Breast Imaging (scintimammography): For newly diagnosed breast cancer

Fertility Support

Get the Treatment You Need While Persevering Your Ability to Have Children

There’s a reason breast cancer patients often hear, “You are not alone.” Breast cancer is the most common cancer, aside from non-melanoma skin cancer, among women in this country. The Centers for Disease Control and Prevention finds nearly 203,000 women were diagnosed with the disease in 2007, which is the most recent year numbers are available. For some patients, diagnosis carries an even larger burden—worries that life-saving treatment now might prevent the ability to have a child in the future. Our team of physicians at the Fertility & IVF Center understands those concerns and uses the latest technology to give patients more choices and greater hope than ever before.

Personalized Fertility Solutions

Because each patient is different, counseling and treatment is highly-individualized. Options range from shielding ovaries from radiation, to taking proactive measures before chemotherapy could impact fertility. One of the most recent and significant developments for patients involves freezing a woman’s eggs. As opposed to frozen embryos, which also require sperm, eggs can be frozen by any woman to be used at any time.

Another concern of some breast cancer patients is that they don’t want to pass along the same BRCA gene which has affected their lives to their children. Some families closely screen their daughters as they grow, but others don’t want to have that worry consistently looming in the back of their minds. Preimplantation Genetic Diagnosis evaluates embryos before implantation to ensure they don’t carry the BRCA gene. With this screening, the risk of developing breast cancer becomes equal to that of the general population. That shift can be life-changing for families that have had generation after generation of breast cancer. Our team can provide the information and support to help patients make these important decisions for their own families.

High Risk Clinic

Breast Cancer Diagnostics in Washington DC

The High Risk Breast Care Clinic at The GW Medical Faculty Associates is offered at GW Hospital in Northwest Washington, DC. This clinic is tailor made for patients at high risk for developing breast cancer because of a known genetic mutation, for non-mutation carriers with a strong family history, and for patients who have had an abnormal breast biopsy.

This clinic will provide multi-disciplinary care in one location, thereby eliminating the legwork for patients, and increasing its effectiveness. It is a new model for treatment and a home that high-risk patients can call their own.

Reconstruction

Cosmetic Surgery for Breast Cancer Surgery Patients

Breast cancer surgery focuses on removal of a tumor to cure the disease. But doctors can also help patients get something back—whether peace of mind, physical strength, or, in many cases, the sense of wholeness that comes with reconstruction of a new breast. Our Comprehensive Breast Cancer Center teams up with plastic surgeons at The GW Medical Faculty Associates who specialize in breast reconstruction.

The services they offer include:

• Rebuilding a breast after mastectomy—using either an implant or the patient’s own tissue (or both)
• Modifying a normal breast to match a reconstructed breast in order to give the best cosmetic result
• Building a new nipple and areola (including tattooing for color)
• Correcting deformities after lumpectomy and radiation
• Preventing lumpectomy deformities by various techniques including simultaneous breast reduction

Pain Management

It’s no surprise that untreated or excess pain significantly interferes with a person’s recovery after surgery. Conventional paravertebral block (PVB) is effective in alleviating pain associated with breast care treatment during procedures ranging from simple biopsies to complex mastectomies with reconstruction.

Benefits of PVB

PVB reduces both short and long term pain. This nerve block delivers numbing medication directly to the affected area, and therefore has fewer side effects than stronger, narcotic medications, and it’s long lasting. Patients using PVB report feeling well the day after surgery— though some report experiencing some minor aching and fatigue.

It takes time for patients facing surgery to come up with a list of questions and concerns, have those questions answered, and then feel comfortable about going home with a pump, drains and a catheter, no matter the benefits and the record of success. Still there are distinct benefits for patients who opt to undergo PVB as an option for surgical pain management.

Advantages of PVB:

• PVBs have been shown to reduce chronic pain after breast and thoracic surgery.
• PVB can be performed safely in fully anaesthetized patients.
• There is less sedation, nausea, vomiting, and constipation compared with opioid-based analgesic techniques, as opioid consumption is considerably reduced.
• There is less risk of neurological complications than with most other regional anesthetic techniques.

Our Approach to Breast Pain Management

The Comprehensive Breast Care Program at The GW Medical Faculty Associates and the Acute Pain Service at The George Washington University Hospital employ multi-modal pain control strategies which help manage post-operative pain and post-traumatic pain, including:

• Paravertebral block—Injection of local anesthetic next to the nerves as the nerves exit from the spinal canal. A small catheter may be placed to continuously infuse local anesthetic to the thoracic or lumbar region of the back. This can be done for inpatients or outpatients.
• Multimodal medication management—A combination of pain relief medications, each of which act in a different way, to help control pain.
• Patient controlled analgesia (PCA)—Allows patients to independently and safely self-administer pain medication as needed through an intravenous catheter.
• Peripheral nerve blocks—Injection of local anesthetic next to a patient’s nerve in their arms or legs to reduce pain. A small catheter may be placed to continuously infuse local anesthetic. This can be done for inpatients or outpatients.
• Epidural analgesia—Administration of local anesthetics continuously infused through a small catheter placed in the epidural space in the body, or the space inside the spinal canal.
• Patient controlled epidural analgesia (PCEA)—Allows patients to independently control delivery of pain medication that is administered via a catheter placed in the epidural space.
• Ketamine infusion therapy— An analgesic administered intravenously in low dosages over a period of several days to manage pain.

The Team

The Acute Pain Service team consists of attending anesthesiologists, anesthesiology residents and registered nurses. The team uses its exceptional range of skills, training, experience and knowledge to evaluate each patient’s needs and develop individualized treatment plans.