Breast Cancer Surgery & Prevention


Receiving a new diagnosis of breast cancer or learning of a recurrence of an old cancer can be an incredibly difficult time for anyone, but we’re here to help. Dr. Farkas has extensive experience in treating and helping patients reduce the risk of breast cancer, providing personalized care for your ultimate wellbeing.

Personalized Care & Consultation Cancer Removal Cancer Prevention What to Expect

Dr Rachel Farkas

Dr. Rachel Farkas, MD, FACS

Committed to Quality Outcomes

Dr. Rachel Farkas, MD, FACS, is a highly regarded breast surgical oncologist who has dedicated herself to the care of patients with breast cancer for the past eight years. She has extensive experience in all forms of breast surgery, including traditional mastectomy, skin- and nipple-sparing approaches, hidden-scar breast surgery, and sentinel and axillary lymph node dissections. Her technical expertise, vast knowledge, candor, and compassion make her ideally suited to care for patients who require treatment for breast cancer and those who are at a high risk for developing breast cancer.

Dr. Farkas is certified by the American Board of Surgery and is licensed to practice medicine in New York and in California. She completed her surgical residency and a dedicated Breast Surgical oncology fellowship at the University of Rochester Medical Center, where she served on the teaching faculty for almost a decade prior to joining our practice. She is an active member of the American College of Surgeons, the American Society of Breast Surgeons, and is a member of the physician advisory board of the Breast Cancer Coalition of Rochester.

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Attentive Care & Consultation

Experienced With All Forms of Breast Cancer & Breast Cancer Risk Factors

Dr. Farkas is well-versed in treating all forms of breast cancer, including invasive ductal carcinoma (IDC), ductal carcinoma in situ (DCIS), and invasive lobular carcinoma (ILC). She also has experience treating patients with less common types of breast cancer, including inflammatory breast cancer, Paget’s disease, angiosarcoma, Phyllodes tumors, and patients with benign or premalignant conditions including fibroadenomas, atypical ductal hyperplasia, and radial scars.

Dr. Farkas also has extensive experience treating patients with strong family histories of breast or ovarian cancer, those with known mutations in the BRCA1 or the BRCA2 genes, or those with mutations in one of several other genes that are known to be associated with breast cancer, including but not limited to CHEK2, ATM, TP53, or PTEN.

The Right Surgery for Your Needs

Every individual is at a different point in their journey with breast cancer. Some might benefit from risk-reducing procedures given a high-risk status while others require operative treatment for a newly diagnosed cancer. No matter the situation, we will work with our patients to find the ideal approach that offers the best possible outcome and collaborate seamlessly with oncologists, radiation therapists, pathologists, and all other care providers from across the region. The information provided below will help you understand the various approaches that we take to breast surgery. This list is not comprehensive, just a conversational starting point. We are dedicated to working with all patients to find the path forward that is best for them. If you are interested in reading more extensively, please visit this patient education website, which has very rich information written and validated by certified breast surgeons.
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Heartfelt thanks for all that you have done to help me through such an emotionally traumatic time. I feel that I have been blessed to have such a gifted surgeon. What you do for breast cancer patients is amazing and I thank you for your dedication. — Teresa

Cancer Removal

Lumpectomy (partial mastectomy)

Used for treatment of breast cancer, lumpectomy allows a surgeon to remove the tumor and enough of the surrounding tissue to achieve resection margins that are free from cancer. Typically recommended to patients whose cancers are small and have been detected early, this operation can allow for tumor removal while allowing for most of the breast to remain intact. In cases where lumpectomy is done for breast cancer, radiation therapy is commonly recommended afterwards.

Mastectomy

Simple (or Total) Mastectomy

A simple mastectomy is a procedure in which all of the breast tissue is removed, including the nipple, areola, and skin. The muscles in the chest are not removed, helping to preserve arm strength. Like all forms of mastectomy, this operation can be done with or without breast reconstruction.

In this version of the mastectomy procedure, most of the skin over the breast is left intact, with only the breast tissue, nipple, and areola removed. The amount of breast tissue removed is the same as with a simple mastectomy. Women who are looking for breast reconstruction after their surgery often prefer a skin-sparing mastectomy because it preserves more skin for post-surgery reconstructive procedures.

The nipple-sparing mastectomy is a further variation of the skin-sparing mastectomy. Again,all of the breast tissue is removed, but in this variation the breast skin and nipple are preserved. The surgeon will often remove some breast tissue beneath the nipple and areola during the procedure to check for cancer cells. This variation is ideal for women seeking breast reconstruction after surgery, but is not suitable for all patients and all cancers.

A modified radical mastectomy includes both breast tissue removal along with the clearance of lymph nodes in the axilla (armpit). This operation is reserved for locally advanced tumors that require an aggressive surgical approach.

Cancer Prevention

Bilateral Risk-Reducing Mastectomy

Bilateral mastectomy is the operation of choice for a woman who is at increased risk of breast cancer. This procedure offers the greatest reduction of cancer risk because of the large amount of breast tissue removed. Bilateral prophylactic mastectomy has been shown to reduce the risk of breast cancer by at least 90% in women who carry a mutation in the BRCA1 gene or the BRCA2 gene and by 95% in those with a strong family history of breast cancer. We know that every woman has her own risk profile, and we welcome you to make an appointment to come in and discuss the right approach to your cancer risk.

Contralateral Risk-reducing Mastectomy

In situations where breast cancer is diagnosed in a patient who is at high risk for recurrence or for the development of a second primary cancer in the opposite breast, consideration is given both to the treatment of the known cancer and to risk reduction in the unaffected side. In this context, bilateral mastectomy is considered. This procedure aims to completely remove the breast tissue of both breasts, thereby treating the known cancer on one side and aiming to prevent new cancers on the opposite side. This approach also offers advantages for reconstructive options, as it maximizes the potential for symmetry in the reconstructed breasts.

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What to Expect Before & After Surgery

During Your Consultation

You will meet with Dr. Farkas and her staff to discuss your diagnosis, the various treatment options that are most appropriate, and the optimal timing for surgery. Prior to surgery, you’ll review all the surgical options that are available and select the procedure which best suits your diagnosis, goals of treatment, and gives you the best possible result.

Financing Available Through: Care Credit

Pre-Operation

One week before surgery you'll meet with Dr. Farkas’ staff for a pre-operative visit, where any last-minute questions can be answered and the logistics of your operation will be discussed. On the day of surgery, you will again have an opportunity to meet with Dr. Farkas. She will review your procedure with you and perform an examination to confirm that you’re in good health for your surgery. You may have paperwork to complete or be given prescriptions to fill; we may also take “before” photos, with your permission. As always, we will answer any questions and discuss any concerns so that you feel completely confident as your surgery approaches.

Surgery

Please plan to arrive early to check in and prepare for your procedure. You should wear loose-fitting, comfortable clothes, and leave jewelry and valuables at home. You can expect to remain in the recovery room for several hours following completion of the surgery. When you get home, you may take the prescribed pain medication as needed. Limit your activity for at least the next 24 hours.

Final Preparation

One day before your surgery, confirm the arrangements for your procedure (including transportation) and to prepare your home for a relaxing and comfortable recovery. Shower with antibacterial soap, avoid eating or drinking after midnight, and be sure to follow any other specific instructions provided by Dr. Farkas and our staff. Please remember to avoid Aspirin, blood-thinning medications, vitamins, and other homeopathic medications unless specifically discussed.

Recovery

We will schedule follow-up appointments as necessary throughout your recovery. Your post operative appointment will be scheduled with enough time to review surgical findings and pathology results. Dr. Farkas will assess your healing, remove or change dressings, advise you on activity limitations, and communicate your progress and results with your primary care doctor and any other treating physicians.

Long-Term Follow Up

Depending on the diagnosis, you may continue to follow up in our office with Dr. Farkas and her team.
These instructions will be provided at your postoperative visit.

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Schedule a consultation to learn more about your breast surgery options.

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