November 23, 2009

UAMS’ Klimberg Authors Book on Breast Surgical Techniques

 Suzanne Klimberg, M.D., developed many of the surgical techniques in her new book for surgeons and medical students.

Suzanne Klimberg, M.D., developed many of the surgical techniques in her new book for surgeons and medical students.

Nov. 23, 2009 | The University of Arkansas for Medical Sciences (UAMS) announces the publication of the “Atlas of Breast Surgical Techniques” by V. Suzanne Klimberg, M.D., director of the Breast Cancer Program at the UAMS Winthrop P. Rockefeller Cancer Institute.

Written for practicing surgeons, surgical residents and medical students, the book presents surgical procedures — many developed by Klimberg — intended to improve outcomes for breast cancer patients.

“I have heard many residents say how easy they think breast surgery is. Yet even in these modern times, as many as 40 percent of patients require a second surgery to remove additional malignant tissue,” said Klimberg, who also holds the Muriel Balsam Kohn Chair in Breast Surgical Oncology at UAMS.

The 440-page atlas includes 550 illustrations and operative photos, biopsy specimens, and artists’ renderings of key anatomy. It is part of the Surgical Techniques Atlas Series published by Elsevier.

The atlas’ six sections cover excisional biopsy/partial mastectomy, lymph node biopsy, mastectomy, breast reconstruction, extensive resections and surgical techniques to assist irradiation.

Among the topics presented are axillary reverse mapping (ARM) and excision followed by radiofrequency ablation (eRFA), both procedures developed by Klimberg at UAMS.

eRFA begins with standard removal of the tumor. Then, an RFA probe is inserted and heated to 100 degrees for 15 minutes, creating a one centimeter zone of dead tissue around the cavity. The procedure is intended to give the patient a cancer-free area around the site where the tumor was removed so that a second surgery in the area is unnecessary.

The ARM procedure prevents one of the most common side effects associated with breast cancer treatment — lymphedema or swelling of the arms due to faulty drainage of the lymph nodes.

“The removal and analysis of the lymph nodes under the arm remains the most important factor in determining the severity of disease in breast cancer patients,” Klimberg said.

To prevent the arm swelling, Klimberg developed the ARM procedure. The technique evaluates the ways in which fluid drains through the lymph node system in the arm through the injection of blue dye, thus decreasing the chances of unintended disruption of the lymph node system during surgery and reducing the risk of developing swelling in the arm.

UAMS is the state’s only comprehensive academic health center, with five colleges, a graduate school, a new 540,000-square-foot hospital, six centers of excellence and a statewide network of regional centers. UAMS has 2,775 students and 748 medical residents. Its centers of excellence include the Winthrop P. Rockefeller Cancer Institute, the Jackson T. Stephens Spine & Neurosciences Institute, the Myeloma Institute for Research and Therapy, the Harvey & Bernice Jones Eye Institute, the Psychiatric Research Institute and the Donald W. Reynolds Institute on Aging. It is the state’s largest public employer with more than 10,000 employees, including nearly 1,150 physicians who provide medical care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS’ Area Health Education Centers throughout the state. Visit or