First Combined Mastectomy and Breast Implant at Carbon Campus

Dr. Ali Butash, Temple Plastics Resident Joseph Costa, and Dr. Christopher Sanders perform a double mastectomy and reconstruction at the Carbon Campus.

Two St. Luke’s University Health Network (SLUHN) surgeons, Ali Butash, MD, a general surgeon and surgical oncologist, and Christopher Sanders, MD, a plastic surgeon, teamed up to perform the first combined mastectomy and breast implant procedure at St. Luke’s Carbon Campus.

Dr. Sanders, a board-certified plastic surgeon, joined St. Luke’s earlier this year, making it possible for the patient, who opted for this combined procedure, to have it performed close to her home in February. Previously, patients would have had to travel to St. Luke’s Bethlehem Campus or another location for this procedure.

Carbon Campus COO Joseph Pinto said that it means a great deal to him personally as well as professionally that the combined procedure can be performed in Carbon County. “Many years ago, my wife, a breast cancer survivor, had to travel to our Anderson Campus to have a very similar procedure,”  he said. “Knowing what that was like, traveling back and forth for her care, it’s really special to me that we are able to keep care close to home. It is something truly special that we can now offer this to patients in the Carbon County area.”

A native of Pottsville, Dr. Sanders completed a residency in general surgery at St. Luke’s. His joining the staff at St. Luke’s is a return to his stomping grounds after some years of practice as a plastic surgeon. He, too, is excited to be able to bring plastic surgery to the people of Carbon County and the surrounding communities.

The procedure Dr. Sanders and Dr. Butash performed has been available for quite some time at bigger centers with multiple breast surgeons, plastic surgeons and radiologists, Dr. Sanders said. “I hate it when people have to travel outside their comfort zone, and I am thrilled that we are now able to provide these services for them here,” Dr. Sanders said. Research has shown that patients do better psychologically, and the physical outcomes are often better too when patients can receive the care they need in their own backyard, Dr. Sanders said.

Dr. Butash said that not every breast cancer patient is a candidate for this combined procedure, which involved implanting tissue expanders at the time of the mastectomy. Some women who undergo mastectomy choose to have their reconstruction at a later time, if at all, Dr. Butash said. “Dr. Sanders was great to work with, and I am looking forward to combining cases and giving patients more access to breast reconstruction options in their own community,” Dr. Butash said.

Same-day axillary sentinel lymph node biopsy too

The patient required an axillary sentinel lymph node biopsy during the mastectomy procedure, which is standard. Sentinel lymph nodes are the first lymph nodes to which cancer cells are most likely to spread from a primary tumor. The nuclear tracer required for this procedure was injected by Dr. Butash in the operating room once the patient was asleep, rather than in the nuclear medicine department prior to the procedure -- another first, Dr. Butash said. Before now, patients in this region had been receiving the nuclear tracer injection while awake, which is known to be quite uncomfortable. “With this patient, we were able to do the injection while she was under anesthesia for her surgery,” Dr. Butash said. “Doing it this way is much better for the patient and simpler. It results in less pain and less anxiety for the patient and does not require a separate appointment in nuclear medicine,” she said.

Dr. Sanders anticipates working with other surgeons at the Carbon Campus to perform combined procedures such as hernia repair, reconstructive surgeries for other cancers, particularly head and neck, and for bariatric patients who need skin surgeries because of their extensive weight loss.

“Working with Dr. Butash was a great experience, and working in tandem with other surgeons for more complex cases is one of the most rewarding things in plastic surgery,” Dr. Sanders said.  “I feel it’s a great comfort to patients to know they have an entire team working tirelessly for them to provide them the best care possible.”