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Focused Updates in the Surgical Management of Breast Cancer



 

Breast surgery has evolved significantly in the past several years with new treatments focusing on efficiency and accuracy in surgery, reducing morbidity and improving cosmetic outcomes for breast cancer patients.

New techniques for localizing nonpalpable breast cancer lesions have been developed that ease the work flow and scheduling of lumpectomy procedures.

Based upon large scale metanalysis there is a consensus on adequate margins for breast cancer lumpectomy margins. There are various methods that surgeons can employ to achieve negative surgical margins and reduce re excision rates.

Sentinel node biopsy has revolutionized axillary staging in early breast cancer and newer studies are showing that axillary dissection may have little benefit for most patients. Current studies are looking at utility of axillary dissection in patients who present with clinically positive axillary nodes and receive neoadjuvant chemotherapy.

Good cosmetic results in breast cancer surgery are important to patient well- being and satisfaction. New techniques to improve these results have been a welcome change in breast cancer surgery and oncoplastic and nipple sparing techniques are shown to be safe oncologic procedures as well.

Originally presented on February 10, 2020, in Park City, Utah.


Lecture Presenter

Jane M. Porretta, MD, FACS

Jane M. Porretta, MD, FACS

Assistant Professor of Surgery (Clinical)
University of Utah School of Medicine

Dr. Porretta is a board certified general surgeon specializing in breast surgery. She received her medical degree from Wayne State University in Detroit, MI and surgical training at the University of Utah School of Medicine. She is a fellow of the American College of Surgeons and is an active member of the American Society of Breast Surgeons.

Dr. Porretta's focus is on the surgical treatment and diagnosis of breast cancer. She served as medical director of a community breast center before joining the Huntsman Cancer Institute breast cancer team. She practices techniques in breast cancer surgery for improved cosmetic outcomes including oncoplastic procedures in breast conservation and nipple and skin sparing mastectomies. She has additional training and certification in breast ultrasound and uses this in the clinic and operating room for diagnostic assistance and improved tumor localization. She routinely uses genetic testing in her practice and has been a proponent of genomic tumor profiling to guide more personalized breast cancer treatment.

Since joining the University of Utah and the Huntsman Breast Surgery Group Dr. Porretta has expanded the surgery program in the South Jordan and Farmington Health Center facilities making access to advanced clinical care available to patients living in these communities. Dr. Porretta has been instrumental in bringing new techniques and technologies in breast surgery to the University of Utah/Huntsman facilities. She has supported clinical research enrolling patients in appropriate clinical trials from all Huntsman clinical locations.

Though Dr. Porretta has a special interest in breast surgery, she has extensive experience in general surgery practice. She has been operating for over 25 years performing laparoscopic and open surgical procedures including gallbladder surgery, hernia repair, abdominal procedures, subcutaneous and soft tissue mass excision and lymph node surgery.


Objectives

After this presentation, participants will be able to:

  • Identify new techniques in localization of non-palpable breast lesions
  • Describe surgical management of lumpectomy margins
  • Discuss sentinel node biopsy and axillary management in breast cancer
  • Relate how new techniques in breast surgery improve cosmetic outcomes

Sponsored by:

University of Utah School of Medicine, Department of Pathology, and ARUP Laboratories