• Program Philosophy and Goals
• Surgical Care
• Perioperative Patient Resources
• Research

Program Philosophy and Goals

The breast surgical oncology program at PAMF's Cancer Care Center is a full-service, patient-centered program for screening, diagnosis, treatment and posttreatment surveillance of breast cancer. Our cancer care experts deliver dedicated care in a warm, supportive environment. We engage patients in informed decision making, address your medical and nonmedical concerns and respect
your wishes.
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Surgical Care

Surgery is the primary treatment for breast cancer. Therefore, it is extremely important that a patient with breast cancer receives optimal surgical treatment. At PAMF, we practice the highest standards of care in establishing of pre-operative diagnoses, intraoperative margin assessment by radiological means and evaluation of lymph nodes. To achieve these standards, we use the most advanced equipment available for the diagnosis and treatment of breast cancer, including:

• Dedicated ultrasound machines
  
• Digital mammography
  
• Breast MRI with biopsy capability
  
• Blue-toothed probes for sentinel lymph node biopsy

Our dedicated surgical oncologists are trained in the latest surgical techniques from oncoplastic breast conservation surgery to nipple sparing skin sparing mastectomy (total skin sparing mastectomy). The surgical oncologists work closely with plastic surgery colleagues to achieve bilateral breast symmetry with breast conservation surgery and optimal cosmetic outcomes with breast reconstruction. Reconstruction options range from placement of breast implants to reconstruction with autologous tissue transfers, including free-pedicle TRAM flaps by highly specialized plastic surgeons trained in microvascular techniques.

The surgical oncologists also work closely with radiation oncologists to deliver the most effective radiation therapy. Intraoperative techniques optimize radiation techniques, including partial breast radiotherapy with brachytherapy (internal radiation treatment given by placing radioactive material directly into the tumor or close to it), whole breast radiotherapy with "boost" to the surgical bed, and post-mastectomy chest wall radiation.
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Perioperative Patient Resources

The care of patients with breast cancer and conditions associated with increased risk of breast cancer requires physicians from various surgical and medical disciplines. For patients with breast cancer, we use multi-disciplinary clinics and tumor boards to deliver coordinated surgical care and adjuvant therapies, including radiotherapy, chemotherapy and hormonal therapy.

Our Cancer Care Center offers a variety of dedicated resources and we encourage patients to use them both before and after surgery. In addition to your physicians and nurses, the cancer care support staff includes a dedicated breast care nurse, nurse navigator, social worker, financial counselor, nutritionist and physiotherapist. This additional support can be very helpful during the stressful periods of diagnosis and surgical treatment.
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Research

Our breast surgical oncologists strive to advance patient care by providing leadership in research studies for the prevention, early detection and treatment of breast cancer. They are actively engaged in clinical studies, including a current program to evaluate a breast cancer screening device using red light to establish cell lines for the development of targeted therapies, to investigate sentinel lymph node biopsy techniques, to investigate partial breast radiotherapy treatments, to assess quality of care and to assess patient satisfaction.

These research studies are being conducted in partnership with the Palo Alto Medical Foundation Research Institute, University of California San Francisco, Mastery of Breast Surgery Pilot Program, National Surgical Adjuvant Breast and Bowel Project, Radiation Therapy Oncology Group and American College of Surgeons Oncology Group.
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