NWABCS offers a wide range of services for the diagnosis and treatment of breast disease. Most of the diagnostic procedures listed below are offered in the clinic setting, often at the same time as the initial visit, for your convenience. At your visit, Dr. Menendez will thoroughly discuss with you the most appropriate test or procedure for you. Dr. Menendez treats each person individually, not just the disease process. He takes the time to fully explain the treatment options available and will guide you from start to finish.
core needle biopsy
This is an office procedure that removes small pieces of breast tissue under local anesthesia, that will be examined for signs of cancer. This procedure is usually performed using the ultrasound machine as guidance, in order to obtain an accurate sampling. We can also perform this procedure using a stereotactic device when the suspicious spot is seen only on mammogram. Results are usually back in 24-48 hours.
Surgical procedure to remove a cancerous lump in the breast. Sometimes called a partial mastectomy. Occasionally a wire is placed prior to surgery to mark the cancer in order to guide the surgical procedure.
sentinel lymph node biopsy
Surgical procedure usually performed with a lumpectomy or a mastectomy in order to identify the first lymph node that drains from the breast under the arm. Usually a radioactive injection and a blue dye is used to help locate the lymph node. This biopsy is an alternative to complete removal of all the lymph nodes under the arm.
This is a surgical procedure performed to remove the entire breast, usually due to a breast cancer diagnosis. There are many types of mastectomies, including skin-sparing and nipple-sparing mastectomies, where much smaller incisions are made. Some patients elect to remove the opposite non-cancerous breast (prophylactic mastectomy). We also offer consultation with a plastic surgeon to discuss reconstruction options.
*All illustrations courtesy of physician and
artist Moises A. Menendez, MD, FACS
This is a noninvasive test that uses sound waves to examine the breast. With the patient lying on their back, a handheld device (transucer) is placed on the breast and an image will appear on the screen. This test is helpful when examining the breast for lumps or changes seen on a recent mammogram. Ultrasound can also be used to aid diagnostic procedures, such as a needle biopsy of the breast, or a cyst asipration.
This is a surgical procedure to remove a nipple duct, commonly performed where there is suspicious nipple discharge. This procedure is performed in the operating room.
Surgical procedure to remove a non-cancerous lump in the breast. An example is a cyst or a benign fibroadenoma. This is performed in the operating room.
A stereotactic breast biopsy is performed when an abnormal finding is seen only on a mammogram, and not on ultrasound or on physical examination. On the mammogram, this can either be a mass or nodule, or small spots called microcalcifications. If Dr. Menendez suggests a stereotactic biopsy, then he can perform this procedure at the various breast imaging locations in the area.
This is a procedure that is commonly performed in the office. Under local anesthesia, a needle is placed in the breast in order to draw out fluid from a cyst. Ultrasound is usually used during this procedure as a visual aid.
fine needle aspiration
This is an office procedure that utilizes a small needle to obtain a small sampling of cells, such as those from a lymph node. This is commonly performed using an ultrasound for guidance and is helpful to determine if cancer cells have spread to any suspicious lymph nodes.
axillary lymph node dissection
This is a surgical procedure performed where there is known cancer involving underarm lymph nodes. In contrast to the sentinel lymph node biopsy, many more lymph nodes are removed.
drainage of abscess/infection
Some infections in the breast may form pockets of infection that may need to be aspirated or drained. This can usually be performed in the office using ultrasound for guidance. Occasionally an operation may be performed when the infection is severe.
coordination with reconstructive/plastic surgeon
Many patients will be referred to a plastic or reconstructive surgeon when a mastectomy is planned to discuss options for reconstruction. Many times we perform the mastectomy and the reconstruction during the same surgical procedure.
Dr. Menendez is well trained in genetic syndromes related to breast cancer and will counsel patients on their individual risks for breast cancers. For those patients who are deemed high risk, genetic testing (BRCA) can be offered and performed in the office.
partial breast irradiation catheter placement
When planning partial breast irradiation therapy, a special catheter is placed into the breast that will deliver radiation internally to the lumpectomy site in a very precise manner. This can reduce the radiation therapy course to just 5 days.