Eleni Tousimis, MD
- Surgery - Breast
Dr. Eleni Tousimis is a breast surgeon at the New-York-Presbyterian Weill-Cornell Medical Center, and is an Assistant Professor of Clinical Surgery at Weill Cornell Medical College . She plays a very active role in resident training, serving as Associate Program Director of Surgical Education.
Dr. Tousimis graduated from Albany Medical College in 1996 and spent the next five years as a general surgery resident at the Guthrie Clinic in Pennsylvania. She graduated the program in 2001 and went on to become a Fellow at Memorial Sloan Kettering Cancer Center from 2001 to 2002 and then spent the last year as an International Fellow at the European Institute of Oncology in Milan, Italy.
A highly skilled clinician, researcher, and teacher, Dr. Tousimis is trained in the latest technological advances in the treatment of breast disease, specializing in minimally invasive techniques. She enjoys an outstanding reputation for excellence and commitment among her professional colleagues, her students and her patients.
Surgery - Breast
Surgery - General
English, Greek, Spanish
Albany Medical College
Guthrie Clinic in Pennsylvania
Memorial Sloan Kettering Cancer Center
american medical women's association: board member, metropolitan breast cancer society of new York: treasurer, executive member, new York physicians society.
Areas of expertise:
Breast Cancer Mastectomies, Breast Disease, Breast Surgery, Sentinel Node Biopsy For Breast, Sentinel Node, Mastectomy, Reconstruction Breast Cancer Surgery
the clinical management and treatment of breast cancer
Awards and publications:
The City of New York: Achievement Award for Significantly Contributing to the People of New York , Providing High Quality Surgical Skilla, Education and Compassion. Presented by the Office of the NYC Comptroller, William C. Thompson 2009
Most Widely Read Breast Cancer On Line Article: Bilateral Breast Cancer 2005
"Excellence in Teaching Award" presented by Weill Cornell Medical College in June 2004
For publications see: http://www.weillcornell.org/physician/eatousimis/publications.html
New-York-Presbyterian Weill-Cornell Medical Center
425 East 61st Street 10th Floor
New York, NY
Practice phone number:
Affinity Health Plan
Empire Blue Cross Blue Shield
Neighborhood Health Providers
Personal Bio (My story)
Dr. Eleni Tousimis is a highly skilled, experienced breast surgeon, who provides the highest quality, compassionate patient care. She specializes in state-of-the art minimally-invasive treatment options for breast surgery.
Pain can occur after lumpectomy due to fluid collection, scar tissue as well nerve involvement. The pain does usually resolve over time. Everyone is different and it depends how extensive the surgery was and how long your body takes to reabsorb the fluid and scar tissue. If the pain is caused by nerve involvement this might take longer to recover from.
This is true. In the United States, most surgeons cannot get clear margins approximately 20% of the time after lumpectomy. This is because of microscopic disease which is disease that is too small to see with the naked eye. I always explain to may patients that some tumors have these microscopic extensions which is impossible to see during the surgery. Only the pathologist can see this small disease when examining the tissue under the microscope. Some surgeons always take additional margins at the time of lumpectomy in order to decrease the 20% need for reexcision.
There are many state of the art less invasive procedures available to women undergoing breast cancer treatment. These procedures range from nipple sparing mastectomy, new reconstructive materials, new anesthetic options and partial breast radiation.
From the surgical standpoint, many women undergoing mastectomy are candidates for nipple sparing mastectomy. This procedure entails performing the mastectomy via a bra line incision which is barely visible. The entire skin and nipple/areola are left intact while removing the underlying breast tissue. A reconstructive surgeon can reconstruct the breast at the same time. The cosmetic result of this type of mastectomy as compared to a traditional mastectomy is far superior. It is important that the surgeon selects the patient for this type of surgery very carefully ensuring that the cancer is not located near the nipple and the margins are all clear. Data so far have shown that the risk of local recurrence with this type of mastectomy is the same as the traditional mastectomy.
In the reconstructive field, there has been the development of many new implant shapes and materials that achieve superior cosmetic results while necessitating less surgery. These new materials allow the reconstructive surgeon to adequately cover the implant after mastectomy. In some cases this allows the patient to have a one stage reconstruction thereby avoiding future reconstructive surgeries.
In the anesthetic field, many patients undergoing mastectomy in my practice are opting to undergo epidural anesthesia or spinal blocks prior to general anesthesia. This causes numbness of the chest area after the surgery. By having less pain after surgery, there is less need for pain medication and thus less risk of nausea and vomitting. This in turn shortens the time in the recovery room as well as shortens the hospital stay.
In the radiation oncology field, many surgeons are offering partial breast radiation to select patients with small tumors. This is a balloon catheter that is placed in the lumpectomy bed at the time of lumpectomy. Instead of the traditional 6 weeks of whole breast radiation, patients are receiving a 5 day course of radiation to the lumpectomy bed only. Thus far, the data has been promising showing equal local recurrence rates compared to the traditional 6 week course.
Breast cancer surgery and treatment has changed dramatically in the last decade toward the more minimally invasive with superior cosmesis, less pain while maintaining similar local recurrence and survival.
Statistically, the number of women less than 40 years old with breast cancer is rare only about 5% of all breast cancers. However, I do feel that I see many young women with breast cancer with young children in my practice. But this could be a bias since I practice in New York City where there is a large population of gene carriers of the BRCA gene. These patients tend to be affected by the disease at an earlier age. Also, many young women with breast cancer are referred to my practice. These women diagnosed at a young age can be very complex since they have many additional issues facing them such as preservation of fertility, genetic counselling, possible prophylactic removal of ovaries as well as a normal breast, body image and sexuality. It is important when treating a young woman with breast cancer, that the surgeon works closely with a team of specially trained medical oncologists, fertility specialists, genetic counselors, gynecologic oncologists and therapists to address all these issues as necessary.
There are two lymph node surgical procedures used to either identify or treat lymph node disease. The most accurate and reliable test to identify axillary disease is the sentinel lymph node biopsy. The sentinel lymph node is the "gate keeper node" of all the lymph nodes in the armpit. If cancer has spread from the breast to the nodes in the armpit, it will reliably travel to the sentinel lymph node before going to other nodes. The accuracy of this biopsy is about 99%. Women with invasive breast cancer who do not have evidence of lymph node disease should undergo a sentinel lymph node biopsy at the time of either lumpectomy or mastectomy.
If the sentinel lymph node biopsy shows evidence of cancer, the patient should discuss with their surgeon and medical oncologist whether they would benefit from removal of additional lymph nodes from the armpit. In the past, surgeons routinely removed additional lymph nodes when there was evidence of cancer in the sentinel lymph node. However, new data this year has implied that some women undergoing lumpectomy and radiation may not benefit from the removal of additional nodes. Therefore, at our institution we take these patients on a case by case basis to determine whether they would benefit from further surgery.
If patients have evidence of axillary lymph node disease prior to surgery, they should undergo a lymph node dissection at the time of either lumpectomy or mastectomy in order to remove the disease from the armpit. Traditionally, this involved the surgical removal of about 10 lymph nodes. Anytime a woman has cancer involvement of lymph nodes and has surgical removal, there is a risk of lymphedema after the surgery. Lymphedema is the chronic swelling of the arm which has no curative treatment. Other risk factors for developing lymphedema are obesity and radiation to the armpit after surgery.
Each of us has about 50 lymph nodes under each armpit. The purpose of lymph nodes is to filter the lymphatic circulation. If a breast cancer was to spread, it would travel to the sentinel lymph node or "gate keeper node" first before spreading to the other lymph nodes in the armpit. The sentinel lymph node is identified by injecting either one or two dyes into the breast. The most common "dye" is a radiotracer that the nuclear medicine doctor injects into the breast before the surgery. Another dye is a blue dye injected by a surgeon into the breast during the surgery while the patient is asleep. Each dye is picked up by the lymphatic circulation in the breast and travels to the sentinel lymph node making it either radioactive or blue. This is how the surgeon can identify the node and surgically remove it to have the pathologist check it for cancer.
Most surgeons will use a combination of both the radiotracer and blue dye to identify the sentinel lymph node. However, some surgeons will rely on only one type of dye. In my practice, I usually only use the radiotracer since the blue dye can result in a blue stain on the skin and in rare cases an allergic reaction. There is no way to surgically find the sentinel lymph node without the injection of either the radiotracer or blue dye into the breast.