Published on June 27, 2016

Breast cancer surgery without the scarsbreast-cancer-surgery

For women facing the trauma of breast cancer, a surgical scar is often the last thing on their mind. But, afterwards it can be a permanent reminder of their illness.

Kathryn Dalton, DO, a breast surgeon at Cape Cod Hospital, felt the disease was upsetting enough, without the added worry of having a visible scar.

For the past three years, she’s been perfecting ways to perform lumpectomies and mastectomies with as little disturbance to the outer breast as possible. Her technique now includes hiding the scar under the fold of the breast or under the arm, using the natural contours of a woman’s body to conceal it.

An Illuminating Idea

“I had been trying to be creative with my patients because I wanted things to be as cosmetically pleasing as possible,” Dr. Dalton said. “I worked on developing new and improved methods to hide the scars.”

When she learned about the Invuity Hidden Scar™ approach, she immediately realized this was the solution she’d been looking for.

To perform the Hidden Scar procedure, the surgeon makes discrete incisions in the breast and then uses a special lighted surgical instrument called a retractor to visualize the entire breast cavity. This allows the removal of the tumor and surrounding tissue with minimal invasion, and then closure of the skin in a way that prevents dimpling.

Deborah Young-Kroeger of South Dennis thought she would need a mastectomy when doctors discovered two tumors in her breast. But, after consulting with Dr. Dalton, she was relieved to learn she was a candidate for the Hidden Scar procedure. Her surgery was last November 5 and she said she is “beyond ecstatic” over the results.

“My new breast looks better than my other one,” she said. “The only actual incision you can see is where the lymph node was removed.”

Dr. Dalton performed a lumpectomy using “oncoplastic” surgery on Young-Kroeger. This involves employing plastic surgery techniques to reshape the breast and prevent deformities.

When Young-Kroeger thought she was going to have to endure the disfigurement of a mastectomy, she said it “made the whole situation so much worse.”When Dr. Dalton assured her she could take out the tumors while preserving the breast, she was so relieved.

“She is so terrific,” Young-Kroeger said. “They all are (at Cape Cod Hospital).”

The Hidden Scar technique can also be used for benign breast diseases.

The procedure is as effective as traditional breast cancer surgery in that it has the same recovery time and, most importantly, the same success rate, Dr. Dalton said.

Dr. Dalton is certified by Invuity for the procedure and has performed hundreds of Hidden Scar surgeries. She is now a member of the Invuity faculty and teaches the procedure regionally.

The State’s First Hospital for Hidden Scar Surgery

Dr. Dalton was the first doctor in Massachusetts to perform the Invuity Hidden Scar™ breast surgery, and the first to offer it at Cape Cod Hospital. Now, she and fellow Cape Cod Hospital breast surgeon Jill Oxley, MD, are two of the few surgeons in the state that perform the procedure. The technique includes lumpectomies and nipple-sparing procedures.

The Hidden Scar technique is done by making an incision in the mammary fold under the breast and then reconstructing the breast using an implant. The procedure is done under the skin, which allows the surgeon to leave the nipple intact.

The procedure is “state-of-the-art, from lumpectomies to nipple-sparing,” Dr. Dalton said.

This is great news for the roughly 400 women who are diagnosed with breast cancer at Cape Cod Hospital each year, she said.

Dr. Dalton has seen breast cancer and its aftermath first-hand. Her grandmother had breast cancer and her mother has lobular carcinoma in situ (LCIS), which is an area of abnormal cell growth that can lead to breast cancer.

Dr. Dalton’s primary goal is to make people happy with their results.

“At the beginning, patients say they just want the cancer out,” she said. “Later on, patients are happy with the way they look. There’s no deformity, no obvious reminder of cancer after they heal.