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Desiree D'Angelo, DO, FACS

Tel: (609) 204-5357

Fax: 609-272-7755

Locations

Egg Harbor Township
2500 English Creek Ave.
Bldg 600, Suite 605
Egg Harbor Township, NJ 08234



Cape May Court House
106 Court House South Dennis Rd.
Bldg 200, Suite 200
Cape May Court House, NJ 08210



Cape May Court House
215 North Main Street
Cape May Court House, NJ 08210

Tel: (609) 622-4058

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FAQs

Usually breast cancer—unless it is quite advanced—is painless.

Breast pain may have multiple origins, including but not limited to: fibrocystic changes, cysts, infection, hormonal cycle, trauma, dietary factors, inflammation from external sources, etc.

If you have breast pain, it is a good idea to see your breast physician for a workup, diagnosis and treatment.
Only 5 percent of all breast cancers are related to pathologic genes ( i.e., BRACA, amongst other pathologic genes).

However, your family history can put you in a higher risk group for breast cancer.

If you have a family history of breast cancer you should see your breast physician for a discussion of the appropriate screening modalities available to you.
Most breast callbacks are for further diagnostic views and imaging by other modalities and result usually in clarification of the question by imaging alone. Some imaging abnormalities will require biopsy. Most of these can be done with a needle and do not require open surgery. Most breast biopsies will yield benign, noncancerous results (80 percent or more).
The current treatment of breast cancer is multimodality, involving surgery (breast and plastics), medications (chemotherapy, hormonal therapy, immunotherapy) and frequently radiation (e.g., whole breast vs. partial breast). Treatment recommendations will be discussed based on your personal history, risk assessment, the type, size, and location of the breast cancer you have, your personal habitus and your preferences. Two patients with the exact same breast cancer may elect for treatments at different ends of the treatment spectrum. For example, Patient A with a 2 cm tumor in the upper outer quadrant of her 34C breast may elect for breast conservation and radiation with post-op hormonal therapy. Meanwhile, Patient B with the exact same breast size, tumor size, type and location may elect to have both breasts removed, reconstructed and forego radiation and future imaging. Yet for these two patients, though these two treatments will yield equal outcomes, each for various reasons was the correct treatment for the individual patient.
Current data does not support routine contralateral prophylactic mastectomy (CPM) in normal risk individuals. Fear of getting breast cancer in the opposite breast is the least well-supported reason for having the normal breast removed (i.e., the surgical risks of having the breast removed and reconstructed are greater than the risks of getting cancer in that breast). In fact, unless you have personal risk factors that increase your risk of breast cancer in the normal breast, current research suggests that it may actually be detrimental to your overall health for multiple reasons to have routine CPM. Of course, a thorough discussion of risks, benefits and alternatives should occur with your breast surgeon prior to any breast cancer surgery. In some women who do not have a higher biologic risk, CPM may be the right choice for them because of other non-medical factors.
It is a very good idea to get to know your breasts. A monthly self-exam can make you feel more comfortable with the makeup and appearance of your breasts, but more importantly will allow you to know if something is new (i.e., It wasn’t there before). Most lumps are benign, especially if they have a history and are non-changing. However, new and growing lumps warrant a visit to your breast physician and should usually be investigated.
There is not one specific sign of breast cancer. However, there are a constellation of findings that should warrant a trip to the breast physician. Such signs include but are not limited to changing lump, new /changing swelling or edema of the skin, an ulcerating skin wound, retraction (pulling in) of the skin, a change of breast shape, new nipple discharge, a new crusty appearance to the nipple/areola, a new lump in the armpit.
Most women do not require a screening breast magnetic resonance imaging (MRI) scan. These are usually reserved for high-risk women (lifetime calculated risk over 20 percent), and/or women who have had a biopsy showing a high-risk lesion (e.g., atypical hyperplasia, lobular carcinoma in situ).

Breast MRIs are indicated in some breast cancer patients before surgery to exclude disease in the opposite breast and to evaluate the extent of disease in the affected breast. The decision for a breast MRI will usually be made after discussion with you by your physician and is usually based on your personal risk factors, your age and the type of breast cancer you have.

Breast MRIs are frequently performed for women receiving chemotherapy or hormone therapy before surgery to gauge the response of the tumor to therapy.
Family history and the chromosomes (genes) we receive from our parents are risk factors that we currently can not change. (Though splicing and repairing pathologic genes may become available in the not-too-distant future).

Risks that the individual can control include:

  • Obesity (fat cells in women produce extra estrogen hormone)
  • Alcohol (How much is too much is still being debated. However, most experts agree that alcohol can increase breast cancer risk incrementally)
  • Tobacco (Not only can smoking increase your risk of getting breast cancer, but smokers with breast cancer do worse than non-smokers with breast cancer.
  • Hormone therapy (Hormones, like estrogen, can increase risk of breast cancer. Risk is related to the length of time used. Risk seems to decrease with time once they are stopped)
In some women, nipple discharge can be associated with breast manipulation and/or hormonal changes. This is especially true if the same discharge is present in both breasts.

Most nipple discharge will be from a benign etiology.

A new, spontaneous, unilateral nipple discharge should initiate a visit with your breast physician.
The lymph nodes that receive the initial lymph drainage from a given area of the breast are defined as the sentinel nodes. By using special dyes injected into the part of the breast where the cancer is, the sentinel nodes can be identified. If these nodes do not contain cancer, then the rest of the lymph nodes in the axilla can be left in place. This can reduce the surgical risks associated with a complete lymph node resection.
1) Selective estrogen receptor modulators:
  • Tamoxifen: Original hormone treatment for breast cancer. Can be used in premenopausal women.
  • Raloxifene : Primarily used for osteoporosis. Does reduce risk of certain breast cancers in high-risk individuals.
  • Main risks: Blood clot, uterine cancer, menopausal symptoms.
2)Aromatase inhibitors:
  • Anastrozole, Exemestane: These drugs have been shown to effectively reduce risk of breast cancer in post-menopausal women
  • Risks: osteoporosis, bone pain/muscle cramps, menopausal symptoms
When a breast cancer is removed, the amount of tissue outside of the cancer cells defines the margin.

Currently, most physicians involved in breast cancer care agree that for invasive cancer—as long as the pathologist can demonstrate that all of the outside surface of the resected tissue (margin) is free of cancer cells—an adequate excision has been done.

For ductal carcinoma in situ, because of the way this grows, a clean margin of at least two mm is recommended.

Inadequate margins are a possible factor in breast cancer recurrence.
Breast cancer cells are seen, but they are still inside of the breast ducts. They are noninvasive. This is felt to represent a pre-cancer or Stage 0 (The horse is still in the barn).

Ductal Carcinoma is graded (1-3). The higher the grade, the more aggressive it can be.

When diagnosed by needle biopsy, it requires further investigation as it may be associated with invasive cancer.
We can be contacted during normal business hours, Monday through Friday- 9:00 A.M. to 5:00 P.M. at 609-204-5357 to schedule an appointment. Urgent problems will be scheduled as soon as the doctor as availability.
Generally, two weeks, depending on the type of procedure.
Minor surgical procedures are sometimes performed in the office setting or at a surgery center. For more complex procedures, they are typically scheduled at one of our affiliated hospitals, either Shore Medical Center or AtlantiCare.
Absolutely! Several procedures can be performed laparoscopically with minimally invasive techniques.
It will depend on the type of surgery. For minor procedures, you may not need time off from work. For abdominal surgeries, there are lifting restrictions after surgery, anywhere from 4- 8 weeks. If your job involves heavy lifting and your employer does not offer "light duty", you may need to be out of work during that period of time. Our office will help with filling out FMLA or short term disability paperwork as needed.
If you are not having anesthesia, then no, you can drive yourself home.

If you are receiving anesthesia of any type (general, twilight, sedation, etc.) a responsible adult (over 18) will have to drive you home. You cannot take public transportation, taxi, or uber/lyft home after having anesthesia.