Conveniently located in Southbury and Prospect, the Breast and Oncology Center is staffed by three highly-skilled surgeons who are trained in some of the most innovative technologies and advanced surgical cancer treatments. All work closely with the medical oncologists and radiation oncologists at the Harold Leever Regional Cancer Center to provide comprehensive care tailored to the needs of each patient.

National Accreditation

The center’s two fellowship-trained breast surgeons, Dr. Beth Sieling and Dr. Nicole Sookhan, are also practitioners with The Breast Center of Greater Waterbury, a partnership of Saint Mary’s Hospital, Waterbury Hospital and the Harold Leever Regional Cancer Center.

In 2011, the Breast Center of Greater Waterbury was awarded a full, three-year accreditation from the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons. This accreditation is considered the “gold standard” in national recognition for quality breast cancer care and ensures that patients throughout Greater Waterbury have access to the highest quality care for breast cancer.

“NAPBC accreditation is a meaningful achievement that reflects not only our commitment to providing state-of-the art, comprehensive care for patients with breast disorders, but the recognition that we effectively deliver that care in accordance with the industry’s highest quality standards,” explained Kevin Kniery, Executive Director of the Leever Cancer Center.

The Breast Center of Greater Waterbury operates as a breast center “without walls,” offering patients access to the expertise of surgeons, medical oncologists, pathologists and radiologists at both hospitals and the Leever Center, Dr. Sookhan said.

“It’s important for our patients to know that we are providing state-of-the-art breast care for cancer with a multidisciplinary approach, which we always have,” Dr. Sieling said.

Specialized Cancer Care

In addition to having two highly skilled surgical breast specialists on staff, The Breast and Oncology Center’s Southbury practice includes Dr. J. Alexander Palesty, a surgical oncologist with Saint Mary’s Hospital. Fellowship-trained at the Roswell Park Cancer Institute, Dr. Palesty’s surgical expertise is specifically indicated for patients who require treatment of:

Beth Ann Sieling, MD, FACS	J. Alexander Palesty, MD, FACS	Nicole Sookhan, MD, FACS, FRCS

While mammograms remain the best available screening tool for diagnosing breast cancer, advances in imaging technology are helping to improve patient outcomes in and outside of the operating room. The Breast and Oncology Center provides access to the latest technology for diagnostic studies including digital mammography, ultrasound and MRI, as well as minimally invasive biopsies.

“We offer better methods for breast biopsy that are less invasive and less anxiety-provoking for women. It’s rare that I take a patient to the operating room for a biopsy,” Dr. Sieling said, noting the procedure can be performed in an office setting, often on the same day of the patient’s initial visit.

Both surgeons also perform breast biopsies for lesions identified by mammogram that are not palpable or visible by ultrasound utilizing Saint Mary’s minimally invasive stereotactic core biopsy system.

Saint Mary’s was among the first in Connecticut to offer patients this safe and accurate alternative to traditional open surgical biopsies to diagnose abnormalities identified by screening mammography. Stereotactic biopsy is performed under local anesthesia and requires no sutures, resulting in less pain and scarring than open surgical biopsy. The procedure is completed in less than an hour and recovery time is minimal. Most patients are able to return to work the same day.

In addition, Dr. Sieling offers catheter placement for patients who qualify for partial breast irradiation as a treatment option. Dr. Sookhan's areas of expertise include nipple sparing and skin sparing mastectomies, oncoplastic techniques in breast surgery, and minimally invasive breast biopsies.

Genetic screening for breast and ovarian cancer

For a select group of patients, a genetic mutation passed down from one generation to another can play a significant role in evaluating a women’s risk of both breast and ovarian cancer.

Genetic testing for mutations in BReast CAncer Gene 1 (BRCA1) and BReast CAncer Gene 2 (BRCA2) are available at both the Southbury and Prospect locations. One of theses inherited gene alterations can increase a woman’s risk of developing breast cancer in her lifetime by up to 50 to 80 percent, and increase her risk of developing ovarian cancer by up to 44 percent. Greater than 90 percent of breast cancers are not genetic, but rather are sporadic and influenced by numerous other factors.

Testing is appropriate in a selective population of women who themselves have been diagnosed with breast cancer under the age of 50 or have had bilateral breast cancers or ovarian cancer at any age. Those who have a personal or family history of bilateral breast cancers, premenopausal breast cancers, or male breast cancers may also be appropriate for testing. Ashkenazi Jewish ancestry and family or personal history of ovarian cancer also increases risk of BRCA.

What is the value of knowing BRCA status?

Although it is important for all women to be educated in the value of early detection through breast self exam, screening mammography, and annual physical exam, BRCA carriers may benefit from earlier mammography, additional screening tools including ultrasounds and Magnetic Resonance Imaging (MRI), and more frequent surveillance.

The test is also an important decision-making tool for patients undergoing surgery.  For example, a young woman diagnosed with breast cancer who tests positive for the BRCA1 or BRCA2 mutation has a subsequent breast cancer risk of 40 to 60 percent compared to 10 percent for those who are BRCA negative. She may choose mastectomies and reconstruction (including prophylactic mastectomy of the noninvolved side) rather than breast conservation. Because of the ovarian cancer risk, some women also consider bilateral oophorectomy or total hysterectomy to likewise reduce their risk of ovarian cancer.

“There are challenges younger women who are diagnosed with breast cancer face,” Dr. Sookhan noted. “Breast cancer in young women may be more aggressive and less likely to respond to treatment. In a young woman the breast tissue is generally denser and by the time a lump is felt the cancer may be more advanced.”

“It is important for women to examine their breasts monthly, have an annual clinical breast examination, and not ignore warning signs such as a breast lump or unusual nipple discharge,” she said.

Another subset of women who may benefit from BRCA testing are those with the appropriate strong family history who themselves do not have breast cancer, but who are at increased risk. Determining the degree of risk is important in deciding what action to take. Sometimes women’s perceptions of their risk far exceeds the actual risk.

BRCA testing is only appropriate for a select group of patients. When carefully chosen and when performed with comprehensive counseling to ensure complete understanding of both positive and negative results, it is a valuable tool in the fight against breast cancer.

Resources

www.breastcancer.org

Living Beyond Breast Cancer - http://www.lbbc.org/