Location Details
AdventHealth Medical Group Breast Surgery at Celebration
To request an appointment, please call Call407-303-4760.
Our Services
- Breast surgery
- Medical oncology
- Oncology
- Radiation oncology
- Surgical oncology
- Social Work
Multidisciplinary Breast Cancer Care
We provide world-class evaluation and care for patients with diagnosed breast malignancies. Our physicians from multiple specialties work together to provide the full range of medical and surgical therapies and will work with you to determine which ones are best for you.
During your appointment, you’ll meet with your care team — including a medical oncologist, breast surgeon and radiation oncologist — who will discuss an appropriate course of treatment and answer your questions, all within a single visit. This coordinated approach to your care means you spend less time traveling to medical appointments and start receiving the care you need, faster.
- Patients meet with a medical oncologist, breast surgeon and radiation oncologist as part of a single, coordinated visit all on the same day
- Customized treatment planning in a single visit
- Centralized care means you spend less time traveling to medical appointments
- Begin your treatment as quickly as possible
Understanding Your Treatment Options
As you begin your treatment journey, it’s essential to realize that beyond traditional treatment, everything you eat, the way you feel and your mindset can play a role in your healing. It’s why we examine your whole health before prescribing your individual treatment plan. It’s also important to know that because no two breast cancer diagnoses are the same, not every patient will follow the same course of treatment. Instead, your oncology team will personalize your course of treatment strategically, prescribing individual therapies as needed. Depending on your diagnosis, your treatment plan may include some, none or all of the therapies below.
- Chemotherapy
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Chemotherapy Treatment: What to Expect
Nothing matters more to us than getting you well, and getting you home. Depending on the specific characteristics of cancer, chemotherapy may play an essential role in successfully treating it. From the moment you arrive for your chemo treatment, one of our nurses will be there to greet you and guide you, keeping you and your loved one informed, comfortable and in good spirits throughout your visit.
How Does Chemotherapy Work?
Using a combination of specialized drugs, chemotherapy has the power to destroy or slow down the growth of fast-growing cancer cells by finding and eliminating them, wherever they may be. It can be administered intravenously or orally. Chemotherapy has long been used to treat breast cancer. As new drugs are emerging worldwide, we’re always exploring how to make them available to you through clinical trials. Depending on your stage of breast cancer, your dedicated oncology team will determine which drug or combination of drugs makes the most sense for you.
Chemotherapy may be the only treatment you receive, or, more commonly, used in combination with surgery and/or radiation therapy. Along the way, we're here to help however we can, answering any questions and helping you stay strong and optimistic before, during and after your treatment.
- Radiation
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Radiation Therapy: What to Expect
While radiation therapy is one of the most common treatments for breast cancer, at AdventHealth Cancer Institute, we do it with uncommon expertise, guidance and compassion. Using sophisticated radiation technology, we can target tumors with amazing precision, easing your pain and leaving healthy tissue untouched. Depending on your diagnosis, your dedicated team may recommend radiation alone, but in many cases, we combine it with surgery, chemotherapy and hormone therapy.
How Does Radiation Therapy Work?
Our oncology experts take an individualized approach to every patient’s treatment plan. Using the same energy as X-rays, radiation therapy targets specific areas of the body, shrinking tumors and killing cancer cells by damaging their DNA.
When treating breast cancer, radiation therapy is usually delivered one of three ways:
- External radiation delivers radiation in a concentrated beam to keep nearby healthy tissue unaffected.
- Internal radiation is guided by ultrasound or using our MRI-guided HDR brachytherapy.
- Intraoperative radiation therapy (IORT) combines radiation treatment with a surgical procedure, meaning shorter treatment times and more efficient dosing.
Throughout your treatment, your nurses and your radiology care team are there to keep you and your support system informed, comfortable and uplifted.
- Surgery
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If surgery is part of your treatment plan, it’s reassuring to know that your health is in the hands of specialized surgeons. As a recognized leader in breast cancer care, we’re helping patients heal through innovative surgical care day in and day out.
Options for Surgery
Breast cancer surgery can be individualized depending on your specific diagnosis, tumor biology, and extent of tumor in your breast. After reviewing your medical history and test results, your medical team will recommend the most effective treatment plan for you. Surgery may be the only treatment you need, but may be used in combination with chemotherapy and/or radiation therapy.
The extent of breast cancer surgery is typically one of the following pathways:
- Lumpectomy, or partial breast surgery, is used for tumors that can be removed in their entirety while leaving a significant amount of the normal breast tissue remaining. This would then, in most circumstances, be followed by radiation.
- Mastectomy means the entire breast is removed and is usually for larger tumors, or for those tumors associated with a high-risk genetic finding.
Another pathway is the use of surgery following the completion of chemotherapy first.
Regardless of what procedure you need, from pre- to post-op, we’ll be there with open arms to ease you into your recovery.
- Hormonal Therapy
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We’re always looking to improve your care. One way we can try to do that is with hormone therapy, an innovative treatment that may be an option depending on your specific cancer and your personal care plan. Hormone therapy blocks receptor sites on tumors that otherwise signal breast cancer cells to grow, helping to slow or even stop the disease in its tracks.
How Does Targeted Therapy Work?
Rather than risk hurting healthy cells, targeted therapy harnesses the power of new proteins, genes and drugs to attack cancer cells while keeping healthy cells safe. So while we’re treating your cancer with all our strength, we take every measure we can to help you keep yours.
- Reconstruction
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After a mastectomy or double-mastectomy due to breast cancer, some women choose to undergo breast reconstruction surgery. At AdventHealth, we offer patients a variety of reconstruction options that are tailored to their individual needs.
Among these is an innovative reconstructive option known as a deep inferior epigastric perforator (DIEP) flap procedure.
During DIEP flap surgery, fat, skin and blood vessels are cut from the wall of the lower belly and moved up to your chest to rebuild your breast. Your surgeon carefully reattaches the blood vessels of the flap to blood vessels in your chest using microsurgery. No muscle is used to rebuild the breast.
Benefits of DIEP Flap Surgery
DIEP flap breast reconstruction offers advantages over alternative surgical options including:
- Doesn’t degrade over time like many synthetics do
- Faster recovery times
- Lower risk of losing abdominal muscle strength vs. other procedures
- Reduced postoperative pain
- Uses your body’s own tissue to rebuild the breast, making it a more natural option in comparison to prosthetic reconstruction
Is DIEP flap right for you?
While DIEP flap breast reconstruction is popular, it isn’t for everyone. If you fall into any of the following categories, you are likely not a good candidate for the DIEP flap procedure.
- Thin women who don’t have enough extra belly tissue needed. However, there is a newer “stacked” approach that can sometimes work for women in this category. The surgeon takes tissue from the lower abdomen and stacks it to provide the volume needed to reconstruct the breast.
- Women who have already had certain abdominal surgeries, including colostomy (surgery that attaches the large intestine to an opening in the abdominal wall) or abdominoplasty (tummy tuck).
- Women whose abdominal blood vessels are small or not in the best location to perform a DIEP flap.
Experienced Care You Can Trust
The DIEP flap procedure requires special surgical training and expertise in microsurgery.- We have an AAAASF*-certified operating room with recovery onsite — ensuring a high-quality surgical and postsurgical care experience.
- Our team has performed over 900 microvascular procedures in the last seven years.
- Our team approach reduces our average operating times by six to eight hours less than the national average.
*American Association for Accreditation of Ambulatory Surgery Facilities
- Lymphedema Treatment
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Lymphedema is a chronic disease that occurs due to an abnormality or injury to the lymphatic system. When the lymphatic system is injured or abnormal, the lymph fluid cannot drain, and this protein-rich fluid accumulates in the interstitium, leading to debilitating swelling of the involved body part. The most common cause of lymphedema in the U.S. is after cancer treatment, where lymph nodes are removed as part of the treatment, leading to a blockage of the lymphatic flow.
How does lymphedema occur in breast cancer?
In most patients, the lymphatic collectors of the arm drain into the axillary (armpit) lymph nodes. The lymphatic collectors of the breast also drain into the same lymph nodes. In breast cancer treatment, the armpit nodes are sampled to determine if the cancer has spread beyond the breast. This is called a sentinel node biopsy.
Sometimes, if there is cancer in the sentinel lymph node, most of the armpit nodes have to be removed to prevent the cancer from coming back into the axilla (a procedure called an axillary lymph node dissection, or ALND). The risk of developing lymphedema after a sentinel lymph node biopsy is small, but it can still occur. The risk of developing lymphedema after most armpit nodes are removed is much greater, especially if the axilla is treated with postoperative radiation therapy. The risk of developing lymphedema in this situation is about 20 to 30%.
What are the risk factors for developing lymphedema in breast cancer?
- Developing a postoperative infection
- Developing a postoperative hematoma (blood clot in the wound)
- Having a BMI greater than 30
- Performing a mastectomy without reconstruction
- Receiving radiation to the axilla
- Receiving Taxane therapy
- Removing the majority of the axillary lymph nodes (ALND)
- Removing more than six nodes when performing a sentinel lymph node biopsy
What do I do if I develop lymphedema of the arm?
At AdventHealth, we have a surveillance program that will follow you closely after you have started your breast cancer treatment. We will measure your arm volumes over time and use bioimpedance to determine if you are developing an early form of lymphedema. If you do develop lymphedema, you’ll be referred to our lymphatic therapist, who will begin therapy immediately. Our therapists are located on multiple campuses for your convenience.
Therapy consists of performing complete decongestive therapy (CDT), which includes:
- Manual lymphatic drainage: a form of light massage to remove lymph fluid from the affected arm
- External compression: usually a custom-fitted compression garment for the hand and arm that applies pressure on the skin and tissues to prevent the lymph fluid from reaccumulating
- Exercise with compression: encourages the flow of lymph fluid out of the arm as the muscle contracts against a compression garment
- Skin care: this consists of using moisturizing lotion to keep the skin of the arm soft and supple and prevent cracks in the skin, which can lead to an infection (cellulitis)
What happens if I have lymphedema of the arm, and I don’t get it treated?
Once you develop lymphedema, the swelling will worsen over time unless it is controlled with CDT. Once significant swelling sets in the lymph fluid in the tissues, it causes inflammation of the interstitial space, leading to the accumulation of fat cells and scarring, which is referred to as lipo fibrosis. Once you develop this condition, it becomes very difficult to treat the involved arm. You are also at risk of developing serious infections of the arm called cellulitis that may require hospitalization for intravenous antibiotics.
Lymphovenous Bypass
One of the operations we perform is called a lymphovenous bypass in the axilla. This operation is performed before you develop lymphedema and is done at the time of the removal of the lymph nodes (ALND) during breast cancer treatment. In this operation, the lymphatic channels or collectors draining the arm are identified in the armpit using a variety of special dyes. Once the nodes are removed, these channels normally scar down, leading to lymph flow blockage and possible lymph fluid accumulation and lymphedema. Instead of allowing them to scar down, these collectors are sewn directly into an adjacent vein, allowing the lymph fluid to flow directly from the collectors into the vein. This operation significantly decreases the risk of developing lymphedema after an axillary lymph node dissection.
Vascularized Lymph Node Transfer (VLNT)
If you develop lymphedema and are controlling your symptoms with CDT, we can improve the symptoms by performing a vascularized lymph node transfer. In this operation, four to six lymph nodes are removed from another part of your body and transferred to the armpit of the involved arm. The lymph node packet is attached to an artery and a vein in the armpit to provide nutrition and oxygen to the “transplanted” nodes. Once healing has occurred, the lymph nodes will begin forming new lymph channels that will help drain the excess lymph fluid accumulated in the involved arm. The use of custom compression garments is still necessary, albeit the duration of wear per day may be reduced.
Liposuction Debulking
Once you have developed more advanced lymphedema of the arm, the tissues swell not only due to the accumulation of lymph fluid but also due to the accumulation of fat cells and scar tissue. This lipo fibrosis causes the arm to enlarge further, and neither the VLNT nor LVB procedures will help reduce the arm volume. The only means of volume reduction is to remove the fat and scar layer with liposuction. This is often called lipo debulking or suction-assisted protein lipectomy (SAPL). This operation is usually performed six months after the VLNT procedure if necessary.
Our Expert Team, Dedicated to You
Adnan Akhtar, MD
Hematology and Oncology
Francis Pamela Mogollon-Duffo, MD
Hematology and Oncology
Amber Orman, MD, DipABLM, FACLM
Radiation Oncology
Jeremy John, MD, MPH, FACS
Breast Surgery, Surgical Oncology
Ashley D. Anderson, MD
Breast Surgery
Expert Breast Care Coordination
Our breast cancer nurse navigators are available to assist with education and care coordination about your diagnosis — connecting you with a care team and helping you communicate with your doctors. All calls are confidential, free of charge and insurance is not required to talk or meet.
Services Include:
- Serving as a constant link between you and the health care team
- Coordinating care among providers
- Providing education about diagnosis and treatment options
- Expediting the scheduling of appointments, tests and procedures
- Providing access to eligible clinical trials
- Connecting you and your family with support services
- Helping obtain care for uninsured patients
- To speak to one of our breast cancer nurse navigators, call 1-833-EASY NAV, Monday through Friday from 8 am to 4 pm.
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AdventHealth Medical Group Breast Surgery at Celebration
AdventHealth Medical Group Breast Surgery at Celebration AdventHealth Medical Group Breast Surgery at Celebration
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