Breast Surgery

Breast cancer does not fight fairly. It often strikes people in the prime of their lives when they are busy preparing for a 5K, attending their children’s activities or simply just enjoying life. While there are continually innovations for early diagnosis, such as genetic testing and 3D mammography, sometimes with even the most advanced therapeutic care, breast surgery is necessary. Most women with breast cancer that can be treated with surgery have three options: lumpectomy, mastectomy and mastectomy with reconstruction.

When you find yourself or a loved one in the difficult position of needing breast surgery, choosing the right physician can be overwhelming. Penn Highlands Healthcare is here to help.

Women who require surgery due to a diagnosis of breast cancer often remark that finding a breast surgeon who is more than just a doctor – someone who will listen to their questions and concerns -- is a top priority. At Penn Highlands Healthcare, our breast surgeon will guide you through every step of the breast surgery process from the types of surgical procedures and treatments available to expert aftercare.

Services We Provide


Breast Surgery Procedures

  • Minimally Invasive (Stereotactic) Breast Biopsies
  • Lymph Node Biopsies
  • Ductogram for Nipple Discharge
  • Removal of Benign Masses and Breast Carcinomas
  • Partial and Simple Mastectomy
  • Partial Targeted Breast Radiation
  • In Office Genetic Screening and Panel Testing for Hereditary Breast and Ovarian Cancer
Penn Highlands Breast Surgery

1163 Country Club Road
Suite 106
Monongahela, PA 15063

Penn Highlands General Surgery - DuBoisA Service of Penn Highlands DuBois

145 Hospital Avenue
Suite 215
DuBois, PA 15801

Doctor Photo In Network
Furgiuele-Iracki, Natalie, MD, FACS

Breast Surgery


Penn Highlands Breast Surgery

Doctor Photo In Network
Hilliard, Melissa M., PA-C, CGRA

General Surgery


Penn Highlands General Surgery - DuBoisA Service of Penn Highlands DuBois

Doctor Photo In Network
Smith, Kelley R., DO, FACOS

General Surgery


Penn Highlands General Surgery - DuBoisA Service of Penn Highlands DuBois

Surgical Treatments

Removal of Benign Masses and Breast Carcinomas

  • Benign Masses - Most types of benign breast masses do not require treatment. A physician may recommend treatment or removal if you have a type that increases your future risk of breast cancer. Often a lumpectomy will be performed to remove the abnormal breast tissue. During a lumpectomy procedure, the surgeon removes the abnormal tissue and a small amount of the healthy tissue that surrounds it. This ensures that all of the abnormal tissue is removed. A lumpectomy is frequently done as an outpatient surgery. Patients may be given general or local anesthesia for the procedure which takes approximately one hour.
  • Breast Carcinomas - Surgery can be an effective treatment for breast cancer. In some situations, a lumpectomy is performed to remove an isolated tumor. In other situations, a mastectomy, which is removal of the entire breast, may be required.
  • Lumpectomy – Breast Conservation - A lumpectomy is a type of surgery that helps to preserve the breast. It is often used in early-stage breast cancers when the tumor is small in relation to the size of the breast. For people who have a lumpectomy, the breast surgeon will recommend follow-up radiation therapy.

There are different types of lumpectomies which include:

    • Excisional – this is a procedure that removes a tumor for a biopsy to determine if it is benign or malignant
    • Wide-local excision – removes the malignant tumor and some surrounding tissue to test for cancer
    • Re-excision – when the surrounding tissues tests positive for cancer, the surgical site will be reopened to remove additional tissue until tissue comes back cancer-free
  • Lumpectomies
    • Wire localization method– This procedure is less frequently used. A radiologist places a wire down to biopsy proven cancer. The surgeon then uses the wire as a guide to excise the cancer. This procedure is performed the day of surgery.
    • High-frequency tag locator method – A digital tag is placed in the breast where the biopsy clip indicates cancer is present. This then guides the surgeon where to place the incision and guides removal. This procedure can be performed several days prior to surgery for convenience.
    • Radioactive seed localization – This method is not used here due to the radioactive nature and precautions necessary.
  • Mastectomy (including Partial and Simple)

There are different types of mastectomies which include:

    • Simple mastectomy -- removes the entire breast but spares the chest muscle.
    • Double mastectomy – removes both breasts
    • Modified radical mastectomy – in addition to removal of the breast tissue, underarm lymph nodes are removed to reduce the risk of the cancer spreading
    • Nipple- or skin- sparing mastectomy – while the breast tissue is removed, the skin and nipple remain for breast reconstruction – most often used in prophylactic surgery in genetic mutation patients
  • Lymph Node Surgery
    • Sentinel Node Excision – the most common procedure performed. Once the patient is asleep, the breast is injected with a radionuclide and blue dye. Lymph nodes that are high in count and blue dye are removed – sentinel nodes. If the nodes do not show cancer cells, then no further lymph node removal is needed. This procedure decreases the onset of lymphedema.
    • Complete Dissection – may need to be performed in more advanced cancers or if sentinel nodes show cancer cells. This is preferred if the sentinel nodes cannot be identified.
    • Prophylactic Sentinel Node Excision – Often performed in conjunction with mastectomies done genetic mutation.


Partial Breast Radiation with Targeted Radiation Therapy

  • Biozorb – a radiation tissue marker is inserted into the breast cavity. It is made of suture and dissolves within 18 months. It helps radiation oncology know where to perform the breast radiation. Three clips, which are left behind, enable careful breast imaging follow up since breast cancers tend to reoccur in the vicinity of where they were previously.
  • In Office Genetic Screening and Panel Testing for Hereditary Breast and Ovarian Cancer
  • High Risk Follow Up Program - An extensive family history is obtained. Panel genetic testing is performed for patients at a high risk and frequent breast exams are available.

Conditions We Treat


Natalie Furgiuele-Iracki, MD, FACS, Meet Your Provider