Advanced Surgical Associates

Advanced Breast Center

At the Advanced Breast Center of the Advanced Surgical Associates, and with the lead of Dr. Hamad, we take a TEAM approach to breast care.

Treatment: Our surgical team provides the most advanced techniques in the treatment of all breast diseases (benign or malignant), including in office ultrasound and U/S guided Biopsies. We also perform Stereotactic Breast Biopsies, as well as reconstruction and cosmesis.

Education: Our patients are informed about their breasts (via educational library), breast self-exam, treatment options of breast cancer, options of breast cosmesis and reconstruction, and complementary educational materials including books, pamphlets and seminars on breast care.

Aesthetics: Plastic Surgeons on our team provides a wide variety of breast cosmetic and reconstructive options.

Multidisciplinary: We use a comprehensive approach to the diagnosis and treatment of breast diseases.

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Sabah Hamad, M.D., F.A.C.S.

Services Provided

Physical Therapy: Our surgical staff provides instruction on pre and post-operative range of motion exercises that will aid the patient in maintaining optimal function.

Social Services: We provide patients with contacts and resources available in the community and nation-wide regarding breast care.

Support Groups: Our patients are provided information regarding breast cancer support groups and hotlines.

Early Detection of Breast Cancer

Monthly self-breast examinations are critical in noticing lumps or changes in the breasts. The patients themselves find approximately 80% of all breast lumps. Breast self-examinations, along with mammograms, are the most important ways that a patient can help detect breast cancer at its earliest stages. There is really no such thing as "no risk factors" because, 2/3 of all breast cancers are diagnosed in women who have "no risk factors".

Certain things to look for during a breast exam:

  • Any breast lump, particularly if it does not disappear with menses, should be checked.
  • A thickening, fullness, or prominent area in one breast, not felt in the other, should be checked.
  • Any lump felt by a postmenopausal woman should be assessed promptly. Do not wait for a month or two.
  • A rash, or dry, scaly, itchy area in one breast, especially near the nipple, should be checked.
  • Nipple discharge, if it occurs spontaneously, is bloody, or unilateral should be checked.
  • Any dimpling of the breast skin or nipple changes (inverted or retracted) should be assessed immediately.
  • Any lump felt under the axilla, especially if it is only on one side, should be checked.
  • Any man who notices a lump in his breast or chest area should be evaluated (1% of breast cancers occur in men).
  • Sentinel Lymph Node Biopsy

    When a woman is diagnosed with breast cancer, it is very important to assess whether the cancer has spread to the lymph nodes for the purpose of staging, prognosis, and treatment. The traditional standard of care has been to perform an axillary lymph node dissection, which consists of removal of a pocket of lymph nodes from the axilla (arm pit). The number of lymph nodes removed typically ranges from 10 to 20. There are however, long and short term risks/consequences associated with complete axillary lymph node dissection such as numbness in the armpit or the inner arm, decreased range of motion to the upper extremity, and chronic lymphedema which occurs in approximately 10% of women ten years after the surgical procedure.

    "Specializing in Benign & Malignant Diseases of the Breast"

    A new technique is now becoming the standard of care--the sentinel lymph node biopsy. The sentinel lymph node is the primary route of cancer spread along the chain of other lymph nodes; therefore, if the sentinel lymph is negative for cancer then the chance of cancer having spread to other lymph nodes in the armpit is very low (less than 5%). In addition, sentinel lymph node biopsy has been shown to increase the sensitivity of cancer detection in the lymph node by 15%. The technique involves injecting the tumor site approximately 1.5-hrs prior to surgery with a radioactive chemical which is picked up by the lymph nodes. A blue dye is also injected to the same area five minutes prior to surgery and the breast tissue is massaged. During the operation, the "hot" lymph node(s) (containing the radioactivity material), and the "blue" node(s) (containing the blue dye) are removed. One to four lymph nodes on average are removed. The pathologist carefully analyzes the removed lymph node(s). If it is negative for carcinoma, no further node dissection is required. If it is positive for carcinoma then, and only then, is a complete axillary lymph node dissection recommended. Sentinel lymph node biopsy thus offers women a less invasive step process and a better prognostic indicator.

    Based on the criteria endorsed by the American Society of Breast Surgeons, only a few breast surgeons are qualified to perform sentinel lymph node mapping. Surgeons must perform 20 simultaneous sentinel lymph node biopsies and complete lymph node dissections with a false negative rate of less than 5%, and a success rate of 95% or greater. The breast surgeons at the Advanced Breast Center of Advanced Surgical Associates are qualified to perform sentinel lymph node mapping.

    If you have any questions regarding breast disease please call!
    We'll gladly answer all your questions and steer you in the right direction.