Lakeside Women's Hospital

Your healing journey.

It’s news that no one wants to hear. A diagnosis of breast cancer is life-changing and scary. Fear and uncertainty are normal, but we found one of the best ways of dealing with that fear is arming yourself with good information.    

That’s why our mission is to comfort you and bring clarity to your healing journey by providing quality information. Take a minute to explore what breast cancer services we offer and what might be the best fit for you and your lifestyle. 

Because we’re here with you, every step of the way.

Denise Rable, M.D.

Denise Rable, M.D., FACS is a board certified, fellowship trained breast surgical oncologist who has specialized in breast cancer diagnosis and treatment for more than 20 years. Additionally, she completed her certification in Cancer Genetics at the City of Hope in 2016. She has just recently been named the Medical Director of Cancer Genetics at INTEGRIS. Dr. Rable devotes her entire surgical practice to the care of patients with breast conditions. All of her continuing education and research is dedicated to offering the most advanced options for breast surgery in the treatment of breast disease.

Oscar Masters, M.D.

Oscar Masters, M.D., is a board-certified plastic surgeon, who trained at programs such as M.D. Anderson Cancer Center, Shriners Hospital for Children, and the Aesthetic Center for Plastic Surgery. Additionally, he helped develop state of the art techniques in postoperative pain management for tummy tuck procedures. Dr. Masters is Board Certified by the American Board of Plastic Surgeons – the only board recognized nationally for certifying Plastic, Reconstructive and Aesthetic surgeons.

Jeneice Miller, CNP, AGN-BC

Jeneice Miller, CNP, AGN-BC is a board-certified nurse practitioner specializing in genetic testing and counseling, as well as overall breast health.

What kind of services are offered?

INTEGRIS has oncology and surgical services for any part of your cancer journey. From the INTEGRIS Cancer Institute to Lakeside Women’s Hospital, we have one of the best breast cancer treatment teams in the region. Learn more about specific services offered in the dropdown menus below.
Oncologists are specialists in specific cancer fields. Your primary cancer oncologist will assemble a care team around you, including radiation, medical or surgical oncologists. At INTEGRIS, our oncologists are specially trained in the newest life-saving technologies and procedures.

There is no one-size-fits-all treatment plan. Lakeside Women's Hospital is proud to offer a full array of breast surgeries that are specifically chosen for each individual patient’s lifestyle and needs. 

Core Biopsy: This is a needle sampling of a breast lesion to determine a diagnosis. It may be performed with the assistance of breast imaging such as mammogram, ultrasound or MRI.

Excisional Biopsy: This is the surgical removal of a breast lesion to remove a benign symptomatic lesion. Excisional biopsy may also be utilized to establish the diagnosis of an unknown lesion if a core biopsy is not possible.

Lumpectomy/Partial Mastectomy: These are 2 names for the same procedure, also called breast-conserving surgery. This is a procedure where breast cancer and a margin of surrounding normal tissue is removed, keeping as much of the remaining breast as possible.

Oncoplastic surgery: This is a procedure that combines lumpectomy with a cosmetic procedure such as a breast reduction or breast lift.

Mastectomy: A mastectomy is the total removal of the breast.

Nipple–sparing Mastectomy: This is complete removal of the breast, keeping the skin and nipple/areola complex. This procedure is combined with breast reconstruction.

Axillary node dissection: This is the removal of the lymph nodes under the arm, most commonly performed when there is known breast cancer spread to the axillary lymph nodes.

Sentinel node biopsy: This is a more limited lymph node procedure recommended for breast cancer patients with no apparent cancer spread to the axillary nodes to confirm there is no cancer in the axillary nodes.

Breast reconstruction surgery is a form of plastic surgery in which women who have had a mastectomy or partial mastectomy have their breasts surgically rebuilt. There are multiple kinds of procedures available, including DIEP flap procedures, as well as an implant-based surgical reconstruction. 

DIEP Flap Reconstruction

DIEP (deep inferior epigastric perforators) flap reconstruction is a method of breast reconstruction using a patient’s own fat and skin deposits, usually taken from the patient’s stomach. While this surgery can be more complicated, patients who received this reconstruction method report a more natural look and feel to their breasts that lasts a lifetime.

Sources: American Cancer Society and Susan G. Komen


Implant-Based Reconstruction

Implant-based reconstruction is a method of breast reconstruction using silicone or saline implants, often placed under the patient’s pectoral muscle to give soft-tissue coverage to the new breast. This procedure is often simpler, but the silicone or saline inserts will need to be replaced in a few years. Patients also report that the results are less natural-looking than DIEP flap or other tissue graft reconstruction procedures. 

Sources: American Cancer Society and Susan G. Komen

INTEGRIS Breast Surgery has two Nurse Navigators, Fran Chestnut, RN and Kimberly Spillman, RN.

These nurse navigators are a resource for patients, coordinating and expediting their care during the planning and treatment journey.

Inherited Breast Cancer Risk

According to the American Cancer Society, approximately 12-14 percent of breast cancers can be linked to genetic mutations inherited from a person’s maternal or paternal family line. Everyone has the breast cancer gene, commonly referred to as BRCA. When functioning properly, BRCA genes repair cell damage and keep breast, ovarian and other cells growing normally.

However, mutations of the BRCA genes can significantly increase a woman’s risk of developing breast cancer. Mutations of the BRCA1 and BRCA2 genes are most common, although other germline mutations like TP53, PTEN, CDH1, PALB2, CHEK2, ATM, NBN and BARD1 are also associated with breast cancer.

On average, women who test positive for the BRCA1 mutation have a 55 to 65 percent chance of developing breast cancer in their lifetime. The BRCA2 mutation has a 45 percent lifetime risk.

Breast cancers linked to genetic mutations tend to develop in younger women, so it’s important for women to get tested earlier than in past years. Genetic testing is the only way to determine if you have inherited a mutation in your genes that causes breast cancer. Please note: genetic testing does not tell you if you have breast cancer; it just tells you if you are at increased risk for developing breast or other cancers.

Getting Tested For Gene Mutations

Because BRCA gene mutations can drastically increase the risk of breast cancer, many women are getting tested early — in their 20s and 30s — for peace of mind. This type of testing is recommended for women with a strong family history of breast cancer on either the maternal or paternal side. For more information read this article about red flags that may indicate the need for genetic testing.

It’s also important to note that even if a woman has previously undergone genetic testing for BRCA1 and BRAC2 with negative results, she most likely got tested because of a very strong family history of breast cancer. When this is the case, experts like Jeneice Miller, Certified Nurse Practitioner and Advanced Genetics Nurse-Board Certified at the INTEGRIS Breast Surgery Clinic, recommend getting updated genetic testing for the other germline mutations known to increase the risk of breast cancer. 

The breast health services at INTEGRIS include a high risk and genetics clinic at the INTEGRIS Breast Surgery Clinic that offers risk assessment and genetic testing for gene mutations that determine a person’s likelihood of developing breast cancer based on his or her unique risk factors.

The cost of genetic testing varies widely depending on the facility and type of test. However, if you meet certain requirements that indicate hereditary cancer may run in your family, your health insurance company may cover the cost of genetic testing. To find out if you are at risk for inheriting breast cancer, take this quiz.

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