Breast Surgery
Comprehensive and Compassionate Breast Care
Midland Surgical Associates provides experienced, compassionate care for a wide range of breast conditions—from diagnostic evaluation to surgical treatment. Whether you require a biopsy, treatment of a benign condition, or comprehensive breast cancer care, our surgeons are committed to delivering individualized, patient-centered treatment at every stage.
We work closely with imaging specialists, oncologists, and other healthcare providers to ensure coordinated care and clear communication throughout your treatment journey.
Breast Biopsies
Breast biopsies are performed to determine whether a breast lump or area of concern is benign or cancerous. Our surgeons offer the following biopsy options based on clinical findings and imaging results:
Percutaneous Core Needle Biopsy
This minimally invasive, in-office procedure uses ultrasound guidance and local anesthesia to obtain tissue samples from a breast mass using a specialized needle. The samples are examined under a microscope to determine the presence of cancer cells.
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If no cancer is found, we will advise whether monitoring or removal is recommended.
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If cancer is detected, we will discuss treatment options and coordinate care with an oncologist.
Excisional Biopsy
An excisional biopsy involves the surgical removal of an entire lump or suspicious area of breast tissue. The removed tissue is analyzed to determine whether cancer cells are present.
Benign Breast Conditions
Benign breast disease includes non-cancerous conditions that may still require evaluation or treatment.
Benign Breast Masses
Common benign masses include cysts and fibroadenomas—non-cancerous tumors that often occur in younger women. These masses are typically evaluated with a core needle biopsy. Depending on findings, they may be surgically removed or safely monitored over time.
Breast Abscess
A breast abscess is an infection that may require antibiotics and, in some cases, drainage to resolve symptoms and prevent complications.
Nipple Discharge
While nipple discharge can be a normal occurrence, certain types may indicate an underlying breast condition. If discharge is related to a breast lesion, surgical removal of the lesion may be recommended to resolve symptoms.
Breast Cancer Treatment
Breast cancer care involves a multidisciplinary team that may include surgery, radiology, medical oncology, radiation oncology, and plastic surgery. Our surgeons play a central role in coordinating care and guiding patients through diagnosis, treatment planning, and recovery.
After reviewing imaging studies and pathology results, we work closely with you and your healthcare team to develop an individualized treatment plan. When surgery is required, we focus on preserving as much healthy tissue as possible whenever clinically appropriate.
Breast Conservation Surgery (Lumpectomy with Radiation Therapy)
This approach involves removing the tumor along with a margin of surrounding healthy tissue while preserving most of the breast. Lumpectomy is typically performed as an outpatient procedure and is followed by radiation therapy to reduce the risk of cancer recurrence.
Mastectomy
A mastectomy involves removal of most or all breast tissue and may require a hospital stay. Several surgical approaches are available based on diagnosis and patient preference:
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Simple (Total) Mastectomy: Removal of the entire breast, including the nipple and areola
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Nipple-Sparing Mastectomy: Removal of breast tissue while preserving the nipple and areola, often followed by immediate reconstruction
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Modified Radical Mastectomy: Removal of the breast, nipple, areola, and lymph nodes under the arm
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Skin-Sparing Mastectomy: Removal of breast tissue and nipple while preserving most of the skin to support reconstruction
Lymph Node Surgery
Breast cancer often spreads first to lymph nodes under the arm. Surgical evaluation of lymph nodes may be necessary to guide treatment.
Sentinel Lymph Node Biopsy
A small number of lymph nodes are identified using a radioactive tracer and blue dye and removed for testing. This procedure is often performed at the same time as breast surgery.
Axillary Lymph Node Dissection
If cancer is found in the lymph nodes, a more extensive removal of lymph nodes under the arm may be required.
Accelerated Partial Breast Brachytherapy
Some patients who undergo breast conservation surgery may qualify for accelerated partial breast radiation. This involves placement of a balloon or multi-lumen catheter into the lumpectomy cavity, typically performed in-office.
Radiation is delivered through a high-dose-rate (HDR) system over five days, offering a shorter treatment course compared to traditional radiation therapy when appropriate.
BRCA Genetic Testing
Approximately 5–10% of breast cancers are linked to inherited genetic mutations, often seen in families with early-onset breast or ovarian cancer.
We offer in-office genetic testing to determine eligibility. Genetic findings can significantly influence treatment decisions and long-term surveillance.
High-Risk Breast Cancer Screening & Surveillance
Women with a family history of breast cancer or known genetic risk may benefit from enhanced screening and surveillance. Risk assessments and individualized screening plans may include more frequent mammograms and breast MRI to support early detection.
Breast-Related In-Office Procedures
MammoSite® Breast Brachytherapy
Following a lumpectomy for breast cancer, some patients may be candidates for MammoSite®, a form of accelerated partial breast radiation therapy that significantly shortens the duration of treatment.
During this procedure:
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A small balloon catheter is placed into the lumpectomy cavity through a small incision
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The balloon is inflated with saline and remains in place for approximately five days
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Radiation is delivered directly to the surrounding tissue using a high-dose-rate (HDR) machine
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The catheter is removed after the treatment course is completed
This targeted approach limits radiation exposure to healthy tissue and allows patients to complete radiation therapy in a shorter timeframe.
Mammotome® Breast Biopsy
The Mammotome® device is used to perform minimally invasive breast biopsies in the office under local anesthesia and ultrasound guidance.
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Requires only a small incision
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Typically does not require stitches
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Minimal discomfort and recovery time
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Tissue samples are sent to pathology to determine whether a mass is benign or cancerous
This procedure provides accurate diagnostic information while minimizing disruption to daily activities.