Breast Cancer

The Breast Center at Smilow Cancer Hospital provides coordinated, state-of-the-art care for patients with benign and malignant diseases of the breast. For patients diagnosed with breast cancer, we offer dedicated care, innovative treatment options, and cutting edge research, coupled with the recognized excellence of a National Cancer Institute designated Comprehensive Cancer Center. A great deal of progress in the detection and treatment of breast cancer has been made in recent years, and our physicians are on the leading edge of finding even better solutions.

Our Center is accredited by the National Accreditation Program for Breast Centers, and was the first National Cancer Institute Comprehensive Cancer Center in the Northeast to hold this designation. Women with a diagnosis of breast cancer are cared for by a multidisciplinary team of physician specialists, including radiologists, breast surgeons, medical oncologists, radiation oncologists, pathologists, and plastic surgeons.

From the tranquility of the building and the range of services offered by complementary therapy and the boutique, to the most sophisticated personalized therapies and equipment offered in every discipline, Yale offers the perfect blend of art and science to help you through your journey. We are committed to tailoring treatment to you. At different points in time, you may need different resources – at Smilow, we are pleased to provide you with coordinated appointments with all of the appropriate specialties at the right time, accommodating your personal values and schedule.

Although many general surgeons perform breast surgery, there is no question that dedicated breast surgeons have the experience and knowledge to handle difficult or unusual cases and are generally more likely to understand the complexities of breast diagnosis and treatment. The surgeons at our Breast Center perform breast surgery exclusively, and are nationally known as being leaders in their field. Historically, Yale surgeons were among the first to perform a lumpectomy instead of a mastectomy and were instrumental in the development of non-invasive procedures like sentinel lymph node biopsy, intraoperative guidance by ultrasound, and advanced oncoplastic procedures. Our surgeons are experienced in cutting-edge modern techniques, such as skin-sparing and nipple-sparing mastectomy, and often work hand-in-hand with our plastic surgeons to off er women a variety of options for breast reconstruction.

Many patients with breast cancer also need medical therapy, such as chemotherapy and/or endocrine therapy. Our team of nationally renowned experts in breast medical oncology utilizes both standard chemotherapies and new ‘biological’ or ‘targeted’ therapies to attack the cancer specifically, while minimizing harm to normal tissues.

Our medical oncologists are nationally recognized for their contributions to breast cancer research. For example, investigators at Yale helped to elucidate the biology of a cellular receptor called HER2. As a result, our medical oncologists have been particularly successful in developing treatment strategies for HER2-positive breast cancer and have extended this expertise to provide effective therapies for triple-negative/basal-like and hormone receptor-positive breast cancer. They continue to study innovative new treatments, and patients at Smilow Cancer Hospital have the opportunity to receive such novel therapies through exciting clinical trials, many of which are not available elsewhere in Connecticut.

New and complicated patient cases are discussed weekly by the entire team so that every patient benefits from combined expertise. In addition, our medical oncologists are happy to see patients for a second opinion. While many patients opt to have their care at Smilow Cancer Hospital, we work closely with our colleagues at the Smilow Cancer Hospital Care Centers, located throughout Connecticut, to ensure that patients can receive the same high-quality care in the most convenient setting for them.

Radiation therapy is a highly effective and integral part of treatment for many breast cancer patients today. Smilow Radiation Oncology has the most advanced technology in the region, conveniently located throughout the state of Connecticut in New Haven, Hamden, Guilford, Waterford, Trumbull, and Greenwich. The equipment at each Yale radiation therapy site is state-of-the-art, and quality assurance is performed on each individual breast cancer patient to ensure consistent, high level care across all of our Yale facilities. Our Yale physicians practice academic based medicine and collaborate with other Yale specialists to ensure optimal, patient-centered care.

Reconstructions vary from placement of a simple implant to elaborate reconstructions using natural tissue from the abdomen, thigh, or back, for DIEP flap reconstruction. Careful attention is given to achieve the best possible cosmetic result and quality of life, without compromising the chance of cure. In each case, the approach is customized to best fit each patient’s lifestyle and goals.

Our plastic and reconstructive surgeons have adopted an Enhanced Recovery pathway (ERAS), for all DIEP and free flap breast reconstruction surgeries. The pathway encourages the use of regional anesthesia and multimodal pain management techniques to reduce the need for opioids after surgery. Studies at Yale and at other Centers have seen a significant reduction in opioid use, while still adequately managing post-operative pain. Using multiple methods for managing post-op pain can reduce unwanted side-effects of opioids and enables the patient to feel better faster and go home sooner.

One of the most important elements of modern breast cancer treatment is the pathologic evaluation of tumors, and increasingly, the ability to profile tumors allows patients access to novel treatments that may be most effective for treating their particular type of tumor. Yale is fortunate to have one of the finest pathology departments in the country, complete with a high-level tumor profiling service. And, because it operates “behind the scenes,” patients are frequently not aware of its importance. Today, breast cancer is divided into an increasingly complex number of categories based on a whole host of sophisticated molecular markers that were not identified a few years ago. Pathologists, therefore, play a crucial role in our Tumor Board conferences. They carefully review the characteristics of each patient’s tumor, and help the clinical team to define optimal treatment strategies best suited to the individual patient.

The Breast Imaging Center does approximately 89,000 breast studies annually including 50,000 screenings, 10,000 diagnostic tests, 24,000 ultrasounds, 900 MRIs and 3,000 various procedures The newest technology, digital tomosynthesis, creates a three-dimensional picture using breast x-rays for review. This allows our radiologists to look very closely at the breast tissue, often minimizing the need for repeat mammograms. In addition, we offer ultrasound and 3-Tesla breast MRI.

The radiologists at Smilow Cancer Hospital are recognized as leaders in their field and are involved in teaching, both on a local and a national level.

The Breast Center at Smilow Cancer Hospital places great emphasis on taking care of all of our patients’ needs, with the best medical care available and a network of supportive care services. Our intake specialists will ensure that you have everything you need for your first visit with our team, and our clinical secretaries and schedulers will work with you to coordinate your appointments to fit your busy schedule. Physicians at The Breast Center work closely with our patient care associates, nurses, advanced practice providers, and nurse coordinators to ensure that you feel well-informed and supported every step of the way.

Our team extends to a myriad of essential services including social work, pastoral support, dietary and nutritional aid, physical therapy, integrative medicine, pain management, and psychosocial support. In addition, Smilow offers a state-of-the-art Survivorship Clinic that employs a multidisciplinary team approach designed to optimally address patients’ needs after treatment ends. We work closely with collaborators at the Yale School of Public Health, so that women have the opportunity to participate in studies designed to promote health and wellness before, during, and after treatment through interventions like healthy eating, physical activity, and mindfulness.

Smilow Cancer Hospital now offers The PAXMAN Scalp Cooling System, which helps reduce hair loss for people undergoing chemotherapy. To learn more, speak with your physician or visit our web page.

Genetic counseling and testing is an important tool in guiding management and surveillance for patients with breast cancer and their family members. Breast cancer patients with early-onset (<50 years) cancer, a triple-negative breast cancer before age 60 years, or of Jewish ancestry, are candidates for genetic counseling and testing, as are all patients with a family history of a genetic mutation, or of breast, male breast, ovarian, gastric, or pancreatic cancer. Our team of graduate rained and board certified genetic counselors are here to navigate insurance pre-authorization, pre- and post-test counseling, and to ensure that the correct test is ordered and that it is interpreted accurately. In addition, our genetic counselors work closely with a team of specialized breast and gynecologic oncologists, who can provide options for patients at high-risk.