Breast Cancer Q & A with Lance Ludington, MD, General Surgeon

October 23, 2019


Dr. Ludington has over 30 years of surgical experience, performing a wide range of procedures, including breast cancer surgeries. Not every general surgeon takes such an interest in women’s health, but Dr. Ludington was inspired when his family was personally touched by breast cancer. During his early medical education his mother was diagnosed with breast cancer, Dr. Ludington recalled his feelings at the time, “I remember being fearful of what she would have to go through and wondered if she would live long enough for me to graduate from medical school. She was in her early 60s at the time she was diagnosed. She was fortunate to have a wonderful surgeon who believed in breast conservation (lumpectomy).” After a successful treatment his mother lived a long and full life, passing at the age of 94.

With Dr. Ludington’s personal history, education and vast experience caring for women we thought he would be the perfect person to sit down with to learn more about what a breast cancer diagnosis looks like today.

Q: Is it possible to keep the integrity of the breast after a breast cancer diagnosis?

A: Yes! There has been so much progress in breast cancer treatments that a mastectomy is performed only if absolutely necessary. My approach is to keep the integrity while still removing the cancer. The goal is to remove the cancer with a surrounding rim of normal (noncancerous) tissue. This rim does not need to be a large amount of tissue, but it has to be clear of cancer. This gives the patient the best chance of success. Taking additional normal tissue does not improve the outcome. The next goal is to leave the remaining breast in a way that it can heal and retain its normal size and shape. Leaving a woman feeling as close to normal as possible while also giving her the best chance of cure is what modern breast surgical techniques are about.

Q: Do you find that these techniques leave women feeling more confident after surgery?

A: Yes. Certainly, when women can wear their usual clothes and feel good in them that can give them confidence. It is not unusual after breast conserving treatment that it becomes difficult to tell which breast was treated even without clothing. I hear this often from women when they go in for their mammograms.

Q: How does early detection impact patient success?

A: The most important factor is diagnosing a breast cancer as early as possible, when it is still small in relation to the size of the breast. This allows for the greatest chance of cure and excellent cosmetic outcomes. 3-D mammography is able to find breast cancers at an earlier stage (smaller) and see more detail in dense breasts than standard mammography. Finding of breast cancer at an earlier stage (smaller size) improves overall survival after breast cancer treatment and will have the best chance of leaving a woman feeling less of a change going through treatment.

Q: Is there anything you would like to share with your patients?

A: Breast cancer treatment is rapidly evolving and the science behind this is very exciting. There is so much information that it can be overwhelming for women when they are diagnosed and making decisions that will impact them for the rest of their lives. Fear is a common dominant emotion when a woman hears the word breast cancer. Fear can often drive people to make decisions they later regret (such as undergoing mastectomy). I feel being a breast surgeon it is my responsibility to help women with their fear by understanding what they are facing and the choices they have for treatment. In most cases of breast cancer there is no difference in cure or overall survival whether a woman chooses to undergo a mastectomy or breast conservation (lumpectomy). I believe knowledge is power. I find women develop confidence as they gain knowledge of their disease and treatment plan.

Dr. Ludington performs these procedures at Adventist Health Howard Memorial and Adventist Health Ukiah Valley. If you are interested in learning more about your options, we encourage you to ask your primary care provider or oncologist for a referral.

To schedule your annual mammogram in Willits, call 707-456-3090.

To schedule your annual mammogram in Ukiah, call 707-463-7342.