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Starling Physician surgeons have extensive expertise and additional training in the management of breast diseases, both benign as well as breast cancer. They coordinate your care from initial diagnosis and biopsy through definitive surgery and aftercare. Our surgeons are trained in the latest, minimally invasive needle biopsy techniques to get an accurate diagnosis without a formal surgical procedure. They participate in the local/regional interdisciplinary breast team to design state-of-the-art treatment plans with other specialists, including medical oncology, radiation oncology, radiologists, nurse navigators, and occupational therapists.

Diagnoses can often be made with a simple office-based needle biopsy under local anesthesia. If the biopsy does indicate breast cancer, our surgeons can provide expert counseling on your treatment options and make personalized recommendations, connecting you to other providers as needed for complete care.

Treatment of Breast Cancer

Starling Physician surgeons have ongoing interest and expertise in the treatment of breast cancer. Once a diagnosis is made, often with a minimally invasive, office-based guided biopsy, a discussion can begin about the most appropriate treatment options. The following is a summary of the different types of treatments available for breast cancer. Please note that not all of these options will be needed for any given patient.

Surgery: the first treatment after diagnosis is often surgery. The goals of surgery are to remove the breast cancer and to sample the lymph nodes, which are “glands” in the axilla (armpit) and is the first area where breast cancer might spread.

• The two basic types of surgery that can accomplish this are “lumpectomy,” where just the tumor is removed and the rest of the breast is saved, or a “mastectomy,” where all of the breast tissue is removed. Mastectomy is often done at the same time as a reconstructive procedure to form a new breast. Many women can undergo a less radical procedure with excellent results.
• Talk to your surgeon about which of these two options is best for you and the pros/cons of each.

Radiation: some patients will be offered radiation treatments after surgery. This applies to nearly all patients having a lumpectomy and some having mastectomy, as well. The specifics of your cancer and the results from the surgery will determine whether this is the right option for you.

Chemotherapy: some patients will require chemotherapy, depending on several factors. Most of the time, this decision is made after surgery, but if cancer has certain characteristics, it may be better to have chemotherapy before surgery.

Hormone treatments: certain breast cancers can be treated with hormone pills, usually after surgery, to decrease the chance of “recurrence,” or cancer growing back or spreading to other parts of the body later.

At Starling Physicians, we have a dedicated team focused on breast health. This team includes oncologists, surgeons, radiologists, occupational therapists, a social worker, and a dietitian. Together, we provide medical and surgical treatment for both breast cancer and benign breast conditions.

Learn more about the services we provide and our comprehensive approach to breast health. To schedule a visit with Dr. Posner or Dr. Napoletano who specialize in the management of breast diseases, call (860) 826-4457.   

Starling Physician surgeons are specially trained to perform numerous laparoscopic and minimally invasive procedures. These techniques typically have the benefits of reduced pain, accelerated recovery, quicker return to normal activities, and shorter hospital stays (if one is required at all). Below is a partial list of laparoscopic procedures offered:

• Herniorraphy – repair of hernias of the groin, abdominal wall, and other types
• Colon surgery – colectomy for cancer, bowel disease, polyp removal
• Splenectomy – removal of the spleen for various blood diseases or emergencies
• Adrenalectomy – removal of the adrenal gland for endocrine disorders or tumors
• Cholecystectomy – removal of the gallbladder for infection, gallstones
• Fundoplication/paraesophageal or hiatal herniorraphy – repair of hiatal hernia and treatment of reflux disease

Vascular surgery includes care of numerous problems with the blood vessels in the body. Starling Physician surgeons have specialized training in these diseases and their treatments, including:

• Aneurysm surgery – minimally invasive/percutaneous graft procedures for repair
• Venous ablation (“closure” procedure) – for varicose veins and venous reflux
• Carotid surgery – to restore blood flow to the brain
• Bypass surgery – to restore blood flow to the legs
• Dialysis surgery – catheters for dialysis access fistula and shunt procedures for permanent dialysis access
• Venous access – catheters for nutrition, antibiotics, and other needs
• Port-a-cath device for chemotherapy

Venous disease of the lower extremities affects over 30 million people, most of whom suffer indefinitely. Leg discomfort, swelling, and varicose veins may be signs of significant vascular disease. Symptoms may worsen if left untreated.

Dr. Napoletano is our vascular vein care expert and has helped a multitude of patients dealing with troublesome veins. He performs a number of procedures that can bring dramatic relief.

• Treatment is done in the office
• Minimal or no pain
• Same day return to activity
• Typically covered by Medicare and most private insurance companies for cases deemed medically necessary

Any patient with persistent lower extremity swelling or visible varicose veins may be a candidate for the newest non-invasive treatment options. This includes post-partum patients. In addition, any patient with chronic non-healing wounds, such as venous stasis ulcers, may benefit from this procedure.

The first step in the evaluation process is a consultation usually followed by a non-invasive, lower extremity ultrasound. It is completely pain-free and is covered by insurance. 

To schedule a vein screening with Dr. Napoletano, call (860) 826-4457.

Dr. Anne Lally and Dr. Matthew Brown work out of Dialysis Access Center in Newington.  Our Access Center provides a private, outpatient setting where our team can evaluate and treat common problems associated with the catheters, grafts, and fistulas necessary for dialysis access.

Below are some common testing and treatment techniques:

• Angiography: With sophisticated equipment, our physicians are able to examine blood flow through the dialysis access and identify whether there are any obstructions or narrowing in the blood vessels.
• Angioplasty: If there is a narrowing or stenosis, a catheter may be used and a balloon inserted to open up the vessel to optimize blood flow.
• Stent: Should the vessel not open completely or become weakened, a stent can be transported through the catheter as well.
• Thrombectomy: If there is a collection of blood or blood clots blocking or reducing the flow, a balloon and/or a special medicine can be delivered through a catheter to help destroy the clot.
• Embolization: Sometimes there are extra vessels that develop and divert blood flow away from the graft or fistula; when this happens, tiny coils may be deployed through the catheter to close off the accessory veins.

All of these procedures are performed percutaneously, or through the skin, which means that there are no incisions or sutures required. Also, local sedation will be administered to ensure that each patient is comfortable throughout the treatment.

Drs. Lally and Brown can be reached at our Access Center at (860) 665-7070.

Watch the video below to learn more about our Access Center and hear Dr. Matthew Brown discuss how our surgeons make a positive difference in the lives of dialysis patients.