About one in eight women in the United States will develop invasive breast cancer in their lifetime.
Each year, approximately 405,000 women will require a mastectomy or lumpectomy based on the tumor size. Up until recent years, these surgeries were certain to leave behind a visible reminder of breast cancer. All of that has now changed thanks to new technology.
“The age where we leave women scarred and incomplete after breast cancer surgery is over,” says Dr. Alfred John Colfry, III, a breast surgical oncologist at Crescent City Physicians, Inc., a subsidiary of Touro Infirmary. “As breast cancer survival rates continue to improve, we are able to focus on moving beyond extensive, disfiguring surgical procedures,” he says. “The principles of surgical oncology should be integrated with plastic surgery to result in a cure with an appealing cosmetic result. From minimally invasive radioactive seed localization lumpectomy to nipple sparing mastectomy, these surgical approaches significantly impact a woman’s psychological recovery and quality of life.”
Radioactive Seed Localization
Touro Infirmary, a leader in the field of breast cancer treatment, was the first hospital in the Gulf South region to offer radioactive seed localization. RSL allows absolute precision by targeting the cancer for removal and leaving more normal breast tissue undisturbed. It allows the breast surgeon to remove as little breast tissue as possible. This results in a normal looking breast, without a defect, and only a small scar. Prior to being introduced at Touro, the procedure has been performed at major cancer centers, such as MD Anderson Cancer Center, for more than a decade.
Previous methods of performing a lumpectomy for cancer patients involved a guide wire to help surgeons estimate the location of the cancer. With this new method, surgeons forego the wire and instead insert the tiny radioactive seed directly into the cancer. This seed is about the size of a grain of rice, and it gives off a radioactive signal that helps doctors map out the area in 3D and pinpoint the exact location of what needs to be removed. RSL allows for a more precise treatment and helps doctors remove less tissue overall.
“Think of the radioactive seed as a GPS that guides us precisely to the tissue that needs to be removed,” Dr. Colfry says. “We also use RSL for breast lesions that are too small to be seen or felt during surgery and for localizing small deposits of metastatic disease in the axillary lymph nodes.”
Dr. Colfry specializes in the surgical management of breast cancer, including advanced techniques in breast conservation (i.e. lumpectomy), oncoplastic surgery, mastectomy and axillary lymph node surgery. “I’m a big believer in breast conservation, if it can be done safely and effectively,” he says. “The radioactive seed technique allows for more precise intraoperative mapping of the tumor’s exact location and for less breast tissue to be disrupted. This is a win-win when it comes to an improved cosmetic outcome. It represents true breast preservation in that I remove only what is essential.”
Hidden Scar Breast Cancer Surgery
Hidden Scar Breast Cancer Surgery may be appropriate for a wide range of breast cancer patients undergoing nipple sparing mastectomy or breast conserving (lumpectomy) procedures. “We remove cancerous tissue through a single incision made in inconspicuous areas to minimize visible scarring,” Dr. Colfry says. “Whether a patient is having a lumpectomy or a nipple-sparing mastectomy, Hidden Scar surgery allows for optimal cosmetic results. By utilizing this approach, we can preserve a natural-looking breast by sparing the nipple, areola and surrounding tissue. This more sophisticated approach to breast cancer surgery allows a woman to have more self-confidence after having battled breast cancer.”
Dr. Colfry was one of the first surgeons in the New Orleans area to become a certified Hidden Scar surgeon. Patients who undergo this approach have no increased risk of tumor recurrence than patients who undergo any other type of surgical technique.
Sentinel Lymph Node Surgery
Another one of the key innovations in the treatment of breast cancer is sentinel lymph node surgery. This is a less radical procedure that aims to remove the first few nodes that accept lymphatic drainage from the primary breast tumor. Sentinel node surgery provides accurate staging and focuses on the nodes most likely to contain metastatic disease from the primary tumor. Dr. Colfry also places radioactive seeds in cancerous lymph nodes, allowing for a selective node removal and allowing a patient to keep the majority of her lymph nodes. “When lymph nodes are targeted and removed by utilizing RSL procedures, I have had great results in lowering the rate of lymphedema (a condition where the upper arm remains permanently swollen),” Dr. Colfry says. “With this technique, lymphedema can be reduced from 20 percent to 5 percent.”
Skin- and Nipple-Sparing Mastectomy
During this type of surgery, the surgeon removes the breast tumor while saving the breast skin, nipple and areola (darker skin around the nipple). “The eligibility requirements for this type of surgery used to be much stricter, but now 70 to 80 percent of women are eligible,” Dr. Colfry says. “Overall, the chemotherapy is better, and it does a lot of the work for us. Now we just need to focus on keeping women whole.”
Alfred John Colfry, III, M.D.
Medical School: Louisiana State University Health Sciences Center, Shreveport, LA
Residency: General Surgery, Atlanta Medical Center, Atlanta
Fellowship: Breast Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston
JOHN COLFRY, M.D.
Breast Surgical Oncologist
3434 Prytania St., Ste. 410
New Orleans, LA 70115
Dr. John Colfry is a fellowship-trained breast surgical oncologist at Crescent City Physicians, a subsidiary of Touro Infirmary. He specializes in surgical treatment for breast cancer including lumpectomy, mastectomy, breast conservation techniques and oncoplastic surgery. During his fellowship at MD Anderson Cancer Center in Houston, he mastered innovative surgical techniques, such as radioactive seed localized lumpectomy. He also manages benign breast disease as well as high-risk breast cancer patients.