Local breast surgeries increase with the arrival of a specialist
A transformation of breast care services at Columbus Regional Health over the past two years has resulted in new and improved care options for women in the Columbus area.
The enhancements coincide with the September 3, 2020 arrival of Dr. Carlos A. Vieira, a fellowship-trained breast surgeon, to lead the Columbus-based hospital system’s multidisciplinary breast care team.
CRH’s breast care program includes screening mammograms, breast surgery, radiation therapy and medical oncology services, and cosmetic/reconstructive surgery services with a focus on breast conservation. Services are all available on the Columbus Regional Hospital campus.
Incidence statistics demonstrate the importance of breast services, as one in eight US-born women (about 12%) will develop breast cancer at some point in her life, Vieira said.
When he joined Columbus Regional Health, Vieira became the first breast cancer specialist to perform surgeries on local patients. Until then, breast cancer surgeries were performed by general surgeons from the CHR.
Prior to Vieira’s arrival, about 70% of breast cancer patients in the Columbus area sought out breast surgery specialists affiliated with major health systems in Indianapolis, about an hour away, a- he declared.
This trend has reversed in the past two years, with 70% of women in the Columbus area now receiving their breast care treatment within a 15-20 minute drive of their home or business at Columbus Regional Health , Vieira said.
“It took a lot of hard work,” Vieira, 50, said of reversing the trend in patient care, citing overwhelming support within the Columbus community.
“We’re a cutting-edge program that can offer everything that’s offered in any other major hospital system in Indianapolis,” Vieira said.
Innovations that were introduced by Vieira at Columbus Regional Health include:
- Use of anesthetic solution during breast removal, which reduces post-operative pain.
- Use of a special long scalpel blade which can remove hard to reach tumors and allows a better cosmetic result with less visible scars.
- Performing mastectomies without putting a patient under general anesthesia. Instead, the nerves that go to a woman’s chest are blocked. Then the patient is sedated – like someone undergoing a colonoscopy – without pain or awareness of the patient.
This alternative approach to mastectomy is a benefit for extremely sick patients and a safer procedure for healthier patients, Vieira said. This approach can also be used for minor breast surgeries in patients who develop nausea easily or have difficulty waking up after surgery, he said.
While three-dimensional digital mammography has been locally available for several years, an even newer screening technology was introduced after Vieira’s arrival – magnetic resonance imaging (MRI) breast equipment.
The MRI diagnostic test has a much higher sensitivity, able to better detect lesions on the breast that might be missed during a routine mammogram, Vieira said.
It is used for high-risk patients – those with a 20% or greater risk of developing breast cancer, and in some cases for patients classified as having dense breasts, which make it more difficult to detect small breasts. legions.
Vieira holds a distinction that none of her southeast Indiana peers have as the only fellowship-trained breast surgeon in the area.
After practicing general surgery and breast surgery in Shelbyville for 15 years, Vieira completed her one-year postgraduate training at McGaw Medical Center at Northwestern University in Chicago on July 31, 2020.
He is a Fellow of the American College of Surgeons, a scientific and educational association of surgeons founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical training and practice. Completion of the program signifies that the surgeon’s education and training, professional qualifications, surgical skills and ethical conduct have passed rigorous evaluation.
The doctor believes his experience of camaraderie gives him — and his patients — an edge.
“You’ve seen thousands of breast cancer patients,” Vieira said. “You are 100% dedicated to this course. You are attentive to all the advances and techniques.
Five different treatment options are considered for breast cancer patients: surgery, chemotherapy, hormone therapy, biological therapy, and radiation therapy, all available from Columbus Regional Health.
“Every breast cancer is different. Some people will only need surgery. Some will need the full range,” Vieira said.
Surgery is the definitive treatment for breast cancer, performed 99.9% of the time, he said. The only patients excluded from surgery are those whose candidacy is excluded for medical reasons.
Although an important part, surgery is far from the only piece of the treatment puzzle.
Vieira works closely with CRH-certified mammography and ultrasound technologists, nurse navigators, board-certified radiologists, and medical and radiation oncologists to provide comprehensive local breast care services.
Most breast cancer cases require a combination of surgery, radiation therapy and hormone therapy to be successful, Vieira said.
A lumpectomy, in which the surgeon removes the cancer and other abnormal tissue and a small amount of surrounding healthy tissue, accounts for 80% of Vieira’s breast cancer cases and requires radiation therapy, which reduces the risk of recurrence cancer.
A mastectomy, a surgery to remove one or both breasts, does not require radiation therapy, he said.
Second generation doctor
Vieira didn’t have to look far for inspiration to consider a career in medicine. His father, Jose Vieira, of Brazilian origin, has been a doctor in his native country for nearly 50 years and still practices today.
The elder Vieira, a kidney specialist, has grown his private practice treating patients like family, and the younger Vieira strives to do the same.
For example, Carlos Vieira attended the 60th wedding anniversary of one of his patients in August. From his youth, Vieira remembers accompanying his father on weekend social visits to his Brazilian patients to share a meal.
“It comes from my upbringing, seeing how my father took care of his patients,” Vieira said.
Born in New Orleans, where his father was training to be a doctor, Vieira grew up from the age of one in Brazil, where he attended medical school from 1990 to 1997.
“I loved studying – reading, learning to diagnose. I started thinking, how can I impact people in a very fundamental way that will give me purpose? Vieira said, explaining her decision to pursue a career as a surgeon.
Besides the surgery, Vieira learned to interact with patients, empathizing with their care before and after surgery. This helped him become multilingual, influenced by his mother, Sonia Vieira, a retired teacher who gave private lessons in English, the second most common language in Brazil after Portuguese. He also speaks Spanish, which he uses almost daily when speaking with patients from Bartholomew County’s diverse population.
While working as a general surgeon, Vieira realized that helping breast cancer patients brought him special satisfaction.
“Being able to cure breast cancer is very rewarding – emotionally for the patient and also for the provider,” he said.
This fall, Vieira got involved in two grassroots programs organized by students at Columbus North High School for their senior projects.
“Serving for a Cure” was featured Sept. 15 at a Columbus North-Jennings County High School volleyball game. Volleyball player Logan Branstetter’s project was two-fold: raise money for a breast cancer patient while finding out how many local women get regular mammograms.
A project by Rylie Boezeman will provide free breast exams from 8 a.m. to noon on Oct. 29 at the CRH Breast Surgery Department in the Medical Building at 2326 18th St., Suite 230 in Columbus, sponsored by Columbus Regional Health.
“I’m delighted to be here,” Vieira said. “The community has been very supportive. With much joy and hard work, we have been able to improve breast services at Columbus Regional Hospital every day.