WOMEN’S HEALTH
BREAKTHROUGHS
IN BREAST CARE
Chilton Medical Center brings cancer-fighting innovations to the community
A
breast cancer diagnosis is far dif-
ferent today than it was 30 years
ago, when treatment options
were limited in scope and promise. But
we’ve come a long way. Breakthroughs
in research, screening and therapy have
dramatically improved outcomes for breast
cancer patients. In fact, according to the
American Cancer Society, one’s chance of
beating the disease is 40 percent better now
than it was in 1989.
“We have made unbelievable advances,”
asserts Margaret Sacco, MD, medical direc-
tor of breast surgery at Chilton Medical
Center. “When localized or caught in its
earliest stages (stage 0 or stage 1), breast
cancer has a survival rate of nearly 99%.”
With that in mind, Chilton is at the
forefront of breast cancer care, keeping
pace with the newest innovations and
bringing them to the community. Over the
last several years, monumental strides in
breast imaging, surgery, radiation therapy
and medical oncology have revolutionized
the way we detect and treat breast cancer.
A NEW DIMENSION
IN BREAST IMAGING
One of the most significant advance-
ments in breast cancer detection is digital
breast tomosynthesis (DBT), or 3-D
mammography, which combines a series
of X-rays to create a three-dimensional
picture of the breast. According to Dr.
Sacco, the technique is superior to conven-
tional mammography because it provides
a clearer, more detailed image, identifying
lesions that are three to four times smaller
with pinpoint accuracy. While the test is
especially beneficial for women with dense
breast tissue, reducing the need for call-
backs and further imaging, DBT is now the
standard protocol for screening mammo-
grams at Chilton’s Breast Center.
Increasingly sophisticated diagnostic
tools – which also include breast ultra-
sound and breast magnetic resonance imag-
ing (MRI) – allow physicians to find breast
cancer in its earliest stages, when treatment
is most successful.
SURGERY TO RESTORE
HEALTH… AND CONFIDENCE
Cancer survivorship has sparked tre-
mendous progress in surgery. In recent
years, the medical community has expand-
ed its approach by addressing the psycho-
logical and emotional impact of breast can-
cer along with the disease itself. “Removing
the cancer remains our top priority, but
surgical advances have also helped to
enhance cosmetic outcomes,” notes Dr.
Sacco. Newer procedures are aimed at not
only restoring health, but restoring body
image and self-confidence as well.
Chilton’s surgeons are skilled in the
latest techniques for breast-conserving
lumpectomies and mastectomies, including
hidden scar surgery. “Improved instru-
mentation, such as lighted retractors, allow
surgeons to operate through smaller, more
concealed incisions around the dark por-
tion of the nipple or armpit area,” says Dr.
Sacco. “In many cases the scars are barely
visible.”
Nipple-sparing mastectomy is another
notable innovation, enabling surgeons to
remove breast tissue while leaving the skin,
nipples and areola intact. The technique is
a safe, viable option for some women with
early-stage cancers, when tumors are sur-
rounded by clear margins and the disease
does not involve the skin or tissue under
the nipple.
“As microsurgery advanced, we also
discovered new ways of reconstructing the
breast,” remarks Charbel Chalfoun, MD,
a board-certified plastic surgeon special-
SPRING 2019 CHILTON MAGAZINE
izing in breast reconstruction at Chilton.
Utilizing the DIEP flap procedure, for
example, surgeons rebuild the breasts by
taking skin, fat and blood vessels from the
abdominal area. It is similar to the TRAM
flap procedure except the muscle is left
behind, preserving the strength and func-
tion of the abdominal wall. “DIEP flap
reconstruction lowers risk of complication
and side effects while allowing patients
to have natural feeling breasts,” adds Dr.
Chalfoun. Chilton is among few commu-
nity hospitals in New Jersey with the equip-
ment and expertise for this highly complex
procedure.
SAFER RADIATION
Radiation therapy, an important com-
ponent of treatment for many breast cancer
patients, has also evolved.
For many lumpectomy patients, the
first step now begins in the operating
room with a new device called BioZorb™.
Chilton surgeons implant the small, three-
dimensional marker at the tumor bed, pro-
viding a target for radiation treatments and
thus reducing damage to healthy tissue.
Additionally, Chilton recently intro-
duced a specialized radiation technique
called, Deep Inspiration Breath Hold
(DIBH). “While radiation is highly effec-
tive in treating cancer, research suggests an
association with potential heart damage in
patients with left-sided breast cancers from
radiation treatments,” states Joanne Zhung,
MD, a board-certified radiation oncolo-
gist at Chilton Medical Center. “Deep
Inspiration Breath Hold helps minimize
that risk by repositioning the heart away
from the chest wall during treatment and
thereby exposing it to less radiation.”
While radiation is delivered, patients
take a deep breath and hold it for approxi-
mately 15 to 25 seconds. “This allows the