Associate Professor & Chief, Surgical Oncology
Department of Surgery, Surgical Oncology Division
Building 56, Rm 252, Rt 81
Dr. John Butler, MD is Chief of the Surgical Oncology Division and Clinical Director of the Beckman
Laser Institute Breast Health and Research Clinic. Dr. Butler contributes to
clinical studies of breast cancer prevention, detection, and therapy
particularly coordinating multi-disciplinary efforts. Dr. Butler works with Drs
Hsiang, Mehta, Su, and Tromberg.
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Research Profile
1. What
is your breast cancer specialty?
Surgical management of breast cancer
with particular emphasis on skin-sparing mastectomy and immediate
reconstruction, as well as lumpectomy and sentinel lymph node biopsy.
2. Why
is this an important part of breast cancer care?
One of the issues is the adequacy
of surgery. As lesions have become smaller and smaller it has become more and
more appropriate to lessen the surgical procedure. We feel it is critical to
avail all patients who are amenable to minimal surgery. In our hands the
sentinel lymph node biopsy is a well proven technique and it spares the vast
majority of women from an axillary dissection. The importance of that is the
axillary dissection is where the majority of morbidity associated with breast
cancer lies.
For certain women who are high risk or otherwise identified as having truly inherited breast cancer, mastectomy becomes an option. This is really a small subset of the population. In those patients, with the skin sparing technique along with immediate reconstruction we can achieve excellent cosmetics results to the point where it is difficult to see that she had a prior procedure.
3. How
is this different then what might be offered in the community (outside of UC Irvine )?
We are at the forefront of imaging
technology with specialized MRI and Laser studies. We are able to truly
identify the extent of tumor and also rule out the possibility of additional
tumor sites in the breast.
4. What
will my (the patient) experience be like?
At the time of consult, depending
on the work-up she's received so far, we'll review all of the results. I will
examine the patient and present her with options as to the management of her
disease. If there is any indication she should be evaluated for neoadjuvant
therapy (chemotherapy prior to surgery) or other types of therapy prior to
surgery, we will arrange for that evaluation.
On the day of surgery I will see
her preoperatively. The vast majority of surgery is done on an outpatient basis.
This is done where the breast center, and more importantly, where the Imaging Center
is located at the Cancer Center. In those situations where the lesion is non-palpable,
the localizing procedure can be done in the same area and the patient can be
immediately transferred to the preoperative holding area.
Everything is at one place, both
imaging and surgery. If we need other consultations we can arrange for that
right there. Medical oncology is on the same floor and radiation oncology is on
the first floor of the same building. We also work hand-in-hand with the plastic
surgery department where breast reconstruction is a particular strength.
5. What
current studies, or novel options within your specialty are currently
available?
We really have a robust program
with the Beckman Laser Institute, which is a world class research institute
looking at using lasers in a noninvasive way of identifying disease and also
monitoring treatment effects.
For patients with early disease
we're using the latest surgical techniques that minimize both the surgical
incision and extent of the operation.
We really are utilizing the
cutting edge technologies. We offer treatment programs which are recently
developed and even more importantly, we are actually in the forefront of
developing newer technologies in both the diagnosis and treatment of breast
cancer.
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