Mastectomy is the surgical removal of a breast to treat breast cancer. There are different types of mastectomies, and the choice of which to perform depends on the stage of cancer, size of the tumor, size of the breast, and whether the lymph nodes are involved. A total (simple) mastectomy involves the removal of breast tissue and nipple; in a modified radical mastectomy, most of the lymph nodes under the arm and often the lining over the chest muscles are removed, but the nipple may be spared. Mastectomies are major surgery and require a hospitalization. Afterwards, patients will take several weeks to recover fully as the swelling goes down. Physical therapy following the operation is typical, particularly so that patients return to their normal range of motion. Some patients at very high risk of breast cancer, usually as determined by genetic testing and family history, may have double mastectomies to remove both breasts in an attempt to reduce their breast-cancer risk. Many women have breast reconstruction to rebuild the breast(s) after a mastectomy. For breast reconstruction, a breast implant, or a patient's natural skin, fat and muscle, is used to recreate a natural-looking breast.
The UAB Medicine cancer program is ranked among the best in the nation. Patients who come to UAB Medicine for breast cancer treatment have access to the full array of specialists within our system, including medical, surgical, and radiation oncologists, certified oncology nurses, nurse navigators, reconstructive surgeons, and more.
UAB Medicine's Breast Health Center is unique in that we deliver the full range of breast health services including screening, diagnosis, treatment, rehabilitation, and research. Through our Lynne Cohen Preventive Care Program for Women's Cancer, we also offer comprehensive risk assessments and prevention strategies for breast, ovarian, and uterine cancer, arming women with knowledge to make informed decisions about their cancer risk and care. For women whose cancer is now in remission, our Breast Cancer Survivorship Clinic provides the ongoing medical and emotional support they need to remain healthy long after their treatment has come to an end.
As a part of the O'Neal Comprehensive Cancer Center at UAB, our innovative Interdisciplinary Breast Cancer Clinic utilizes a team of dedicated breast specialists to help patients evaluate their options as effectively as possible, which also allows patients and their families to meet with our various team members in one convenient visit. This approach facilitates better communication among team members, patients, and their families. Each patient is evaluated initially by one of our breast specialists before meeting face to face with other team members to discuss long-term treatment planning. Individualized care plans are developed in roundtable discussions and discussed with the patient and family members during the same visit, which allows questions to be asked of each team member.
The UAB Integrative Medicine Clinic features a collaborative approach to patient care among multiple practitioners and utilizes therapies that are proven in both traditional and complementary health care. Integrative medicine combines traditional medical care with programs designed to address the physical, biological, lifestyle, emotional, psychological, and spiritual aspects of health and illness. It focuses on the whole person, including family members, to optimize wellness and manage the challenges throughout each patient’s chronic disease or cancer care journey, from prevention to survivorship and beyond. It encourages the human capacity for healing and emphasizes the relationship between practitioner and patient.
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UAB Hospital first in Alabama to offer first-of-its-kind dissolving heart stent
The interventional cardiology team at UAB Hospital recently added to its longstanding reputation as a pioneer in the development and implementation of stents by becoming the first in Alabama to offer patients with coronary artery disease a new treatment option that disappears over time.
On July 20, Massoud Leesar, M.D., a professor in UAB’s Division of Cardiovascular Disease, implanted a patient with the world’s first FDA-approved dissolving heart stent for the first time in Alabama. The Absorb bioresorbable vascular coronary stent is a major advance in the treatment of coronary heart disease, which is responsible for about 370,000 deaths each year in the United States, according to the National Heart, Lung, and Blood Institute. This type of stent has been in the making for nearly 15 years.
While stents are traditionally made of metal, the Absorb stent is made of a naturally dissolving material called polylactide, similar to dissolving stitches or sutures.
“Since the Absorb stent gradually dissolves, this may be a safer long-term option for patients because metal stents can clot and occlude the artery,” Leesar said.
The stent is placed into the artery on a balloon at the end of a thin flexible tube, much like the procedure used to place bare metal and drug eluting coronary stents. It is then expanded by inflating the balloon that pushes the plaque against the artery wall to enable greater blood flow. The balloon is removed, leaving the Absorb stent to slowly release medication to the diseased area. With blood flow restored, the stent begins dissolving.
After Absorb dissolves, it allows the artery to pulse and flex naturally. It may also reduce the risk of future blockages that occur with metallic stents, and makes it easier for doctors to offer additional interventions in the future if necessary. During the dissolving period, Absorb metabolizes into water and carbon dioxide, two elements that occur naturally in the body. All that remain in the artery are two pairs of tiny metallic markers that enable a physician to see where the device was placed. After three years, the device is completely dissolved and the vessel can remain open and pulsate on its own.
Calvin Burnett of Albertville, Alabama, is the first patient in the state to receive the new Absorb stent. After Burnett was diagnosed with rectal cancer in September 2015, his oncologist recommended he see a cardiologist at UAB following complaints of tightness in his chest.
“I’ve always been kind of physically active, so this kind of threw me for a loop,” Burnett said.
Two days after his stress test, an Absorb stent was placed. Burnett says he is grateful that medicine has come so far.
“I think this is such a great thing,” he said. “I’m looking forward to getting back to riding horses.”
Burnett says he could not imagine having his procedure done anywhere other than at UAB.
To ensure optimal patient selection and implant technique, UAB’s interventional cardiology team underwent extensive training on the new device.
“One of the advantages of this new stent is that the risk of a metal stent’s suddenly clotting is a major issue long-term,” Leesar said. “Since the new stent dissolves over time, this risk can be eliminated, and the vessel has the potential to be open more than to before with the stent.”
Currently, patients who receive the new dissolving stent will have to meet certain criteria. Leesar suggests patients talk with their cardiologists to see if they meet those criteria, and to learn more about the Absorb stent and its capabilities.
Source: UAB News