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Ask the Doctor at Saint John’s: New Surgical Procedures and Treatments for Breast Cancer:

Q. What are the latest surgical procedures and treatments for breast cancer?

A. By Alice Chung, M.D., Assistant Director of the Breast Center at the John Wayne Cancer Institute at Saint John’s Health Center

Annual mammograms are generally recommended for women forty years old or older. In mammography, the breast is compressed in a machine and x-rays are taken. Mammography is a good tool for early detection of breast cancer. Studies show that with early detection there is a decreased mortality rate in women diagnosed with breast cancer.

Since the 1990’s, film mammography was traditionally used. More recently, digital mammography has been developed. With digital mammography electronic photos can be stored in a computer. The digital process gives radiologists the ability to manipulate images, to magnify them and enhance them.

MRI is an up and coming screening method recommended for certain populations at higher risk for breast cancer, such as women with a strong family history of breast cancer or gene mutation carriers (identified in the past few years, BRCA I and II genetic mutation carriers have been found to be at a particularly high risk for breast cancer) and for women who have had high levels of chest area radiation.

There are several different surgical treatments for breast cancer. One is a mastectomy, where the entire breast is removed. Another surgical treatment is breast conservation treatment – a “lumpectomy”- which involves removal of a portion of the breast containing the cancer followed by a five to six week course of radiation.

Traditionally surgery involved removal of all of the lymph nodes which could be very painful and affected a woman’s quality of life. Several years ago, Armando Giuliano, M.D., Chief of Science and Medicine at the John Wayne Cancer Institute at Saint John’s Health Center developed the Sentinel Lymph Node Biopsy. A procedure in which blue dye is injected into the lymph nodes to determine whether the cancer has spread to the lymph nodes. This procedure, sometimes referred to as the “blue node” biopsy due to the use of the blue dye, means that all of the lymph nodes do NOT need to be removed unless cancer is detected in them.

Alice Chung, M.D. is a breast surgeon and the Assistant Director of the Breast Center at the John Wayne Cancer Institute at Saint John’s Health Center. For more information about Dr. Chung and other Saint John’s services please call (310) 829-8990 or visit the website at For a physician referral or a second opinion, please call


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