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Breast Care Center

    St. Clair Hospital’s Breast Care Center offers education, early detection, treatment services and the most advanced diagnostic imaging technology in an environment of comfort and convenience. Our experienced and dedicated breast surgeons and diagnostic radiologists read more than 12,000 mammograms a year. The Breast Care Center’s team of experts consist of two breast surgeons, two plastic/reconstructive surgeons, medical oncologists and radiation oncologists affiliated with UPMC Hillman Cancer Center, radiologists, pathologists, and nurse navigators that help guide patient care and treatment through every step.

    The St. Clair Hospital Breast Care Center specialists work with a multidisciplinary, team-based approach so that our program can provide comprehensive and patient-centered care with clear communication through each service line.

    Our breast care center offers a range of personalized treatment options. Your cancer team will guide you through every step and be there for education, questions and support. This attention ensures you are receiving effective treatment, with peace of mind, while living the best quality of life. Learn more diagnostic tools, treatment options, and survivorship resources below.

    Diagnostic Tools

    Diagnostic tools are tests or procedures that are used to discover breast cancer or benign (non-cancer) breast conditions. It may take several of these tests to get a precise diagnosis and this process is critical in creating a personalized care plan for the patient. It is our goal to guide each patient through the process and reduce wait time between these steps.

    • Mammography:A digital X-ray of the breast (mammogram), this test allows technicians to zoom in on select areas.
    • Breast Ultrasound:High-frequency sound waves are sent through the breast to develop images.
    • Ductogram:For this mammogram, we inject contrast material to get a clear picture of the milk ducts.
    • Magnetic Resonance Imaging (MRI):Breast MRI is used to supplement the information that mammography and ultrasound provides. Powerful magnets and radio waves create pictures of the breast. An IV contrast dye is often injected into the vein of the patient prior to the MRI in order to more clearly evaluate the breast tissue.
    • Breast Biopsy: A procedure done to remove a sample of breast tissue in order to examine it under the microscope for cancerous features.  A biopsy is obtained using minimally invasive techniques. The radiologist will choose a diagnostic tool that best visualizes the area of concern in the breast and use this to guide a biopsy. Prior to the procedure, the breast is numbed with local anesthesia (i.e. lidocaine). A needle is then entered through the skin and used to remove a sample of tissue in the area of concern. This tissue is then sent to the pathology department for further evaluation under a microscope.

    Treatment Options

    Select a treatment option below to view different types of treatment available. 
    Breast Surgery

    Oncologic breast surgery aims to remove cancerous growth from the breast and/or regional lymph nodes. St. Clair’s surgical team has the technical expertise to perform the most advanced surgical and minimally invasive procedures.

    • Partial Mastectomy – This breast conserving surgery is commonly referred to as a “Lumpectomy.” It involves removing the cancerous tissue from the breast through a small incision while leaving the remainder of the healthy breast intact. It allows patients to maintain the overall appearance of their breast with as minimal change as possible.

    • Total Mastectomy – This surgery removes all of the breast tissue. It can be done using several different techniques (see below).  Total mastectomy can be done alone or in combination with breast reconstruction (see below).  The surgeons will help each patient decide which approach is best for them. 
      • Simple mastectomy: All of the breast tissue along with the overlying skin and nipple-areolar complex are removed at the time of surgery.
      • Skin-sparing mastectomy: An incision is made around the nipple-areolar complex. This incision is used to remove the nipple-areolar complex and all of the breast tissue while leaving the skin of the breast(s) for reconstructive surgery.
      • Nipple-sparing mastectomy: The breast tissue is removed while leaving the breast skin and the nipple/areola for reconstructive surgery.
      • Radical mastectomy: A combination of simple total mastectomy, removal of all axillary lymph node tissue and removal of chest wall (pectoral) muscles. This is an extensive procedure that is rarely performed in the setting of modern breast cancer treatment options.
      • Prophylactic mastectomy: Removal of a breast that does not contain cancerous tissue. It can be done using simple, skin-sparing or nipple-sparing techniques. It is considered for patients at high risk of developing breast cancer or to achieve symmetry when one breast is already being removed for cancer.

    • Lymph Node Surgery – Breast cancer cells can travel through fluid-draining channels, called lymphatics, to the axillary lymph nodes in the deep tissue of the armpit. These lymph nodes are often evaluated with surgery.
      • Sentinel lymph node biopsy: The breast surgeon may remove the first-draining or “sentinel” axillary lymph nodes in order to have them examined under the microscope and assessed for breast cancer spread.
      • Axillary lymph node dissection: If breast cancer cells are found in the sentinel axillary lymph nodes then removal of all of the axillary lymph nodes and lymphatic tissue may be required. This is called an axillary lymph node dissection.

    Click here to meet the Breast Surgery team. 

    Breast Plastic & Reconstructive Surgery

    Our breast reconstruction experts specialize in surgically recreating natural-looking breasts to help you maintain your body image and quality of life.  Your plastic surgeon will work with you and your breast oncologic surgeon to develop a personalized plan that helps you achieve your breast reconstruction goals.  We offer the latest techniques in breast reconstruction, including:

    • Muscle-sparing TRAM or DIEP flap, which uses excess lower abdominal skin and fat to reconstruct the breast. The incision for this procedure is similar to an abdominoplasty (or “tummy tuck”). These procedures leave the abdominal muscle mostly or entirely intact and use microsurgery to connect the abdominal tissue to blood vessels in the chest.
    • Breast reconstruction with implants, which can include direct-to-implant reconstruction or two-stage reconstruction with initial placement of a temporary tissue expander.
    • Latissimus dorsi flap, which uses tissue from the back for reconstruction (typically in combination with an implant).
    • Oncoplastic reconstruction, which involves rearranging remaining breast tissue to lift and/or reduce the breast in combination with a lumpectomy for women who choose breast-conserving surgery instead of a mastectomy.
    • Fat grafting, which involves collecting fat from another area of your body using liposuction and then injecting the fat into a contour depression or hollow area where the breast tissue has been removed.

    Click here to meet the Plastic/Reconstructive Surgery team. 

    Medical Treatments

    Systemic (medication based) treatments may be another option to help prevent the recurrence and/or spread of certain types of breast cancer. These may be a part of your breast cancer treatment plan. These medications can be given before or after breast cancer surgery to help prevent breast cancer cells from showing up in other areas of the body. This is called distant metastasis. These medications may also be used if distant metastasis has already occurred. Our Medical Oncologists are responsible for selecting a patient’s customized medical care regimen once they have been diagnosed with breast cancer.

    • Anti-estrogen Therapies:
      • Estrogen can promote the growth of some breast cancers. Anti-estrogen therapies are often pills taken once a day that block production of estrogen or block estrogen molecules from stimulating breast cancer cells. The most commonly used anti-estrogen therapies are selective estrogen receptor modulators (SERMs) and aromatase inhibitors (AIs). Commonly used SERMs include Tamoxifen and Raloxifene (Evista). Commonly used AIs include anastrozole (Arimidex), letrozole (Femera) and exemestane (Aromasin).
    • Anti-HER2 Therapies:
      • HER2 is a protein that sits on the surface of all breast cells. Breast cancer cells with higher than normal levels of HER2 are called HER2 positive. These cancers are likely to respond to drugs that target the HER2 protein. Multiple anti-Her2 drugs exist. The first to be developed was an antibody therapy called trastuzumab (Herceptin) which is given IV. Others include pertuzumab, Kadcyla and Enhertu. Some anti-HER2 drugs are available orally, such as lapatinib (Tykerb), neratinib (Nerlynx) and tucatinib (Tukysa).
    • Chemotherapy:
      • Chemotherapy works by targeting rapidly dividing cells (i.e. cancer cells) and is a powerful tool in treating certain, but not all, breast cancers. It is typically delivered intravenously (IV).
    • Other:
      • There are many other types of breast cancer systemic therapies that may be available to certain patients, sometimes under the direction of a clinical trial. Our medical oncologists have the latest therapies and clinical trials available and will help each patient understand their options.

    Click here to meet the Medical Oncology team.

    Radiation Treatments

    Radiation Oncology uses high-powered energy beams (i.e., X-rays) to shrink or kill cancerous tumors while preserving healthy surrounding tissue. Radiation to the breast is commonly recommended after a partial mastectomy to help prevent the cancer from returning in the breast tissue. It is occasionally used after a total mastectomy and/or for palliation of symptomatic breast tumors. The St. Clair Hospital Cancer Center Affiliated with UPMC Hillman Cancer Center has two state-of-the-art linear accelerators that deliver advanced treatments, including:

    • Deep Inspiration Breath Hold (DIBH)
      • Technique used to significantly remove the heart from the path of the radiotherapy beam
    • Image-Guided Radiation Therapy (IGRT)
      • Is the use of imaging during radiation therapy to improve the precision and accuracy of treatment
    • Intensity-Modulated Radiation Therapy (IMRT)
      • Uses linear accelerators to safely deliver precise radiation to a tumor while minimizing the dose to surround normal tissue
    • Partial breast irradiation (PBI) 
      • For selected low risk breast patients, radiotherapy is directed to the area where tumor was removed

    A Radiation Oncologist is responsible for selecting the patient’s customized, radiation treatment regimen. We participate in national and institutional based breast cancer clinical trials evaluating ways to improve the use of radiotherapy for breast cancer.

    Click here to meet the Radiation Oncology team.

    Survivorship Resources/Patient Education

    Survivorship focuses on the health and well-being of a person with breast cancer. An overall goal of survivorship is to assist patients in learning more about health issues that may occur following completion of their breast cancer treatment and strategies to address these issues and concerns. In addition, there is information on the various steps that can be taken to achieve a healthy lifestyle.

    Meet the Surgeons

    Raye J. Budway, M.D.

    Breast Surgery

    Tara L. Grahovac, M.D.

    Breast Surgery

    Robert W. Bragdon, M.D.

    Reconstructive Surgery

    Edward J. Ruane, Jr., M.D.

    Reconstructive Surgery

    Meet the Radiologists

    Bibianna A. Klepchick, M.D.

    Diagnostic Radiology

    Andrea M. Sanfilippo, M.D.

    Diagnostic Radiology

    Breast Care Center Locations

    Village Square Outpatient Center
    2000 Oxford Drive
    Suite 301
    Bethel Park, PA 15102
    (412) 942-7850

    Peters Township Outpatient Center
    3928 Washington Road
    Suite 270
    McMurray, PA 15317
    (412) 942-7850

    Schedule an Appointment

    To schedule your appointment at the St. Clair Hospital Breast Care Center, please call the specific service department below:

    Breast Surgery
    412.942.7850

    Plastic/Reconstructive Surgery
    412.572.6164

    Radiation Oncology
    412.942.7001

    Medical Oncology
    412.942.3333

    Mammography
    412.942.7800

    Have you scheduled your annual mammogram?

    St. Clair Hospital Breast Care Center

    Annual mammogram screenings can offer early detection and provide instant treatment services to increase better outcomes.

    Learn more about the value of a second opinion and St. Clair’s collaboration with the Mayo Clinic Care Network.

    Let’s Ask the Experts

    Dr. Tara Grahovac answers patient questions about breast health and breast cancer types. She focuses on how to reduce risk of breast cancer. Dr. Bibianna Klepchick discusses the importance of annual mammography screenings and how technology has advanced over the years to help with early detection.