Dr. Holmes is a dedicated breast surgeon providing cutting edge state of the art breast cancer care, including the following:

Breast Cancer Screening and Diagnosis

Evaluation of Breast Lumps, Nipple Discharge, or other Breast Symptoms

Second Opinions to make sure you are making the right treatment decisions

Personal Breast Cancer Risk Assessment to determine which kind of breast cancer screening program is best for you as an individual

Genetic Breast Cancer Screening to determine if you may have or be at risk of developing an inheritable breast cancer

Breast Cancer Surgery

Breast Conserving Surgery (lumpectomy or partial mastectomy) to remove cancers while preserving the shape of the breast

Oncoplastic Breast Surgery to remove cancer while preserving or improving breast appearance, often combined with breast lift or breast reduction

Nipple Sparing Mastectomy (or “Hidden Incision” Nipple Sparing Mastectomy) performed through an incision hidden in the skin fold under the breast

Skin Sparing Mastectomy to remove the breast and areola (including nipple) while preserving the rest of the skin of the breast, followed by breast reconstruction. Performed with areolar preservation is unsafe.

Areola Sparing Mastectomy to remove the breast and nipple (but not areola nipple) while preserving the rest of the skin of the breast, followed by breast reconstruction. Performed with nipple preservation is unsafe.

Total or Simple Mastectomy to remove the breast, nipple, areola, and excess skin when lumpectomy is not possible or desired, possibly followed by optional breast reconstruction

Prophylactic Nipple Sparing Mastectomy to greatly reduce your future risk of developing breast cancer

Breast Reconstruction

Immediate Breast Reconstruction performed at time of mastectomy (preferred)

Delayed Breast Reconstruction if immediate reconstruction is not appropriate or desired.

Types of Reconstruction:

• Breast Implants (silicone or saline)
• DIEP Flap (tummy flap & muscle-sparing)
• TRAM Flap (tummy flap & non-muscle-sparing)
• LAT Flap (using tissue and muscle from back)
• Others from side or thighs

Lymph Node Surgery

Sentinel node biopsy, removal of a few (typically 1-3) lymph node to determine if cancer has spread to the lymph nodes

Axillary lymph node dissection, complete removal of cancerous lymph nodes in the axilla or armpit

Axillary Reverse Mapping, a specialized technique to identify and protect arm lymphatic drainage during lymph node surgery to reduce or prevent lymphedema

Intraoperative Margin Assessment

MarginProbe device, a dedicated device for thorough assessment of surgical margins during surgery to minimize the risk of repeat surgery due to positive surgical margins

Cryoablation (Tumor Freezing)

Cryoablation of breast cancer, a minimally invasive non-surgical treatment of small breast cancers by freezing using a small needle inserted into the breast cancer under local anesthesia

Cryoablation of benign breast tumors, a minimally invasive non-surgical treatment for fibroadenoma, a benign breast tumor common in young women

Breast Radiation Therapy

Single Treatment Targeted Intraoperative Radiotherapy to safely administer breast radiotherapy in a single treatment during surgery at the time of lumpectomy, completely replacing the usual 6-week course of required daily breast radiotherapy administered after surgery.

Neoadjuvant Chemotherapy

Administration chemotherapy or anti-estrogen therapy prior to surgery to decrease tumor size and decrease cancer in lymph nodes to reduce the extent of breast and/or lymph node surgery.