The team of oncoplastic surgeons at WellSpan Health focus on holistic breast care, optimizing cosmetic outcomes. That means that when a lumpectomy is performed and the remaining breast tissue is reshaped, the other breast is reduced in size so both breasts match to give symmetry. The result is a patient who not only feels healthy but looks good as well.
In addition, an oncoplastic surgeon will remove a larger-than-normal margin of healthy tissue along with the tumor to reduce the chance of a second surgery; otherwise, there would need to be another cosmetic reshaping of remaining breast tissue. Oncoplastic surgery expands the indications and possibilities of breast-conserving surgery by allowing for a wider cancer resection than lumpectomy. Indications for oncoplastic surgery include concern about clear margins, poor tumor location, multifocality, need for skin excision, and poor candidacy for mastectomy and reconstruction.
Jaime Slotkin, DO, FACOS, FACS, a general breast surgeon, is part of the expanded team of oncoplastic surgeons at WellSpan. Slotkin has been in practice for 11 years and at WellSpan Good Samaritan Hospital in Lebanon, Pa. for one year. As the director of breast care in Lebanon, she works exclusively with the care and management of both benign and malignant diseases of the breast.
“I feel privileged to be invited into my patients' lives. I help guide women through this process powerfully and with care, so they are more in charge of what's happening to them. As a woman, that resonates with me— breast cancer patients are mothers, sisters, daughters; I have a lot of empathy for what they are going through.”
Oncoplastic surgery requires interdisciplinary coordination among radiologists, oncologists, radiation oncologists, pathologists, and plastic surgeons. A multidisciplinary team of navigators, financial counselors, social workers and the like is also integral to a positive outcome. These non-MD clinicians provide wrap-around support to breast cancer patients.
“When a woman has a breast removed it's removing a part of her body, part of her identity, part of how she feels as a woman, part of her sexuality,” said Slotkin. “With oncoplastic surgery, women look and feel like themselves. In addition to breast reconstruction, oncoplastic surgeons are able to reconstruct a nipple with a tattoo.”
Jaime Slotkin, DO, FACOS, FACS
But oncoplastic breast surgery is not just about breast conservation. Applying oncoplastic principles to mastectomy and reconstruction is just as important. The ability to perform an oncoplastic mastectomy is a basic requirement of any oncoplastic surgeon. Understanding and applying the range of mastectomy techniques available and how they best apply to different oncological and reconstruction options will give patients the best outcomes.
“In general, the medical community does a really good job treating breast cancers,” Slotkin said. “We are screening at earlier ages and there are a ton of resources put into breast cancer research. Despite that, a lot of women have anxiety around a diagnosis of breast cancer. Surgery is always a treatment, but it's how they feel about their breasts that can affect them. It's not vanity. My goal is to treat cancer and ensure the patient is comfortable about how she looks and feels.”
To help women access diagnostic tools and make mammography more convenient, WellSpan launched a mobile mammography motor coach in October 2021. “WellSpan has been reaching out to women in underserved areas,” said Slotkin. “Adding me to the team has expanded our services in Lancaster and Lebanon counties.” WellSpan's team on the mobile unit can complete a private screening in less than 15 minutes, which increases the number of patients seen in a day. If cancer is detected, treatment can begin soon after.
The mobile unit visits rural and underserved communities all across WellSpan's service region of South Central Pennsylvania, including Adams, Cumberland, Franklin, Lancaster, Lebanon, and York counties. The unit visits health fairs and community events as well. These events allow women to receive high-quality mammograms without extensive travel or time away from work. For more information on upcoming locations and to schedule an appointment, visit WellSpan.org/GoMammo.
Furthermore, in late 2022, WellSpan announced a partnership with Helix, the nation's leading population genomics and viral surveillance company, to create a genomics program called the Gene Health Project, designed to improve patient healthcare outcomes. With such a huge genetic component to the development of breast cancer, this partnership is vital.
“This partnership will provide approximately 2,600 physicians and clinicians and their patients with access to critical information to help uncover genetic risk more efficiently to improve health outcomes,” said Helix CEO and cofounder James Liu. “Population genomics will transform healthcare delivery and outcomes, and Helix and WellSpan are leading the way into a future of more personalized medicine for all.” Find more information about the project at WellSpan.org/GeneHealthProject.
These innovations will only provide better outcomes for patients, which leads to them living healthier lives. “I think that in general, for breast cancer, diagnostic tools are better,” Slotkin said. “We now have as tools 3D mammograms and digital mammograms in addition to routine screening. Because of that we find cancers ideally early and when they're really small.”