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it looks cosmetically appealing and is symmetric," Dr. Gordon says. "We're very sensitive and aware of that. We can place incisions in certain places so our patients and other people won't even see them." Of ten, a lumpectomy procedure is followed by plastic surgery to provide the best outcome. "While preserving life and health is our primary goal, we also try to make sure that patients are happy with the cosmetic outcome as well as the oncologic outcome," Dr. Ananthakrishnan says. "We do a lot of combined cases where we can perform a lumpectomy combined with a breast reduction and lift. The patient sometimes ends up with cosmetic results that are actually better than what they started out with." MINIMALLY INVASIVE TECHNIQUES FOR MASTECTOMY Lumpectomy procedures aren't the only thing that have changed as breast cancer research and protocols have progressed. Mastectomies were once maximally inva- sive, often removing unnecessary chest muscle, and performed with little thought to nipple preservation. But advances in technology and changes in thinking have changed mastectomies, and the White Plains Hospital Center for Cancer Care is at the forefront of the new techniques. " W hen appropriate, we per form a nipple-sparing or a minimally invasive mastectomy, typically through an incision at the lower breast where the fold of the breast meets the abdomen," Dr. Gordon says. "By doing that, we create a limited scar that typically will not be seen, and we can leave a breast that looks like a normal breast. We typically work in con- junction with our plastic surgeons, who use a variety of techniques to reconstruct the breast, either using the patient's own tissue or implantable devices." An important part of this reconstruc- tion involves placing implants in front of the chest wall muscle, which decreases the amount of pain the patient experiences and renders the surgical process more efficient, with fewer stages needed. " For cer t a i n patient s, ou r pla stic surgeons are able to perform an implant reconstruction as a single-stage proce- dure, so the patient can have their full reconstruction in one day at the time of their mastectomy," Dr. Ananthakrishnan says. "I think that's where our team at White Plains really shines." The surgeons also utilize anesthetic blocks to lessen post-operative pain — and thus decrease the need for painkillers after surgery. "The idea of a nerve block is that when a woman awakens from anesthesia, she shouldn't have pain," Dr. Gordon says. "And that allows her to take deep breaths, allows her to get out of bed and hastens the recovery. We think this is an important part of care and an important part of our patients' overall surgical experience." " We rea lly wa nt women to be able to return to their baseline function as quickly as possible, with no limitation or restriction on movement or activity," Dr. Ananthakrishnan says. ALL ADDITIONAL SERVICES ON-SITE While having an entire oncology team in the building ensures surgery, radi- ation and chemotherapy protocols a ll happen in coordination, the White Plains Hospital Center for Cancer Care Breast Health Program provides multiple other medical services on-site, including phys- ical therapy. "One of the worries of our patients is that they may experience some functional impairment, especially when we sample or biopsy lymph nodes from the armpits," Dr. Gordon says. "So we're starting a new program called prehabilitation, working with our patients preoperatively to make sure they have a proper range of motion in their arms and shoulders, which should translate into postoperative full range of motion and a faster recovery." There is also a geneticist to provide testing a nd counseling, a long with a holistic nursing team offering massage, Reiki and acupuncture. A social worker provides counseling for patients who need it, and a nutritionist helps patients Preya Ananthakrishnan, MD, FACS PRE YA A N A NTH A K RISHN A N, MD, FACS, is the Director of Breast Surgery at White Plains Hospital Center for Cancer Care. A graduate of the University of Louisville School of Medicine, Dr. Ananthakrishnan completed her residency at the University of Medicine and Dentistry in Newark, New Jersey, followed by a fellowship at the John Wayne Cancer Institute in Santa Monica, California. Before joining White Plains Hospital almost five years ago, Dr. Ananthakrishnan served on the faculty of the Cleveland Clinic and Columbia University College of Physicians and Surgeons and was Director of the Breast Surgery Fellowship at Columbia. Drs. Ananthakrishnan and Gordon practice together at the White Plains Hospital Center for Cancer Care, which opened in 2016 and houses hematology and oncology practices, radiation oncology and an infusion center. 0 8❱❱❱❱❱ C O V E R F E A T U R E

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