Dr. John Butler, MD
Dr. John Butler, MD

Associate Professor & Chief, Surgical Oncology
Department of Surgery, Surgical Oncology Division

Building 56, Rm 252, Rt 81

Dr. John Butler, MD is Chief of the Surgical Oncology Division and Clinical Director of the Beckman Laser Institute Breast Health and Research Clinic. Dr. Butler contributes to clinical studies of breast cancer prevention, detection, and therapy particularly coordinating multi-disciplinary efforts. Dr. Butler works with Drs Hsiang, Mehta, Su, and Tromberg.

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Research Profile

1. What is your breast cancer specialty?

Surgical management of breast cancer with particular emphasis on skin-sparing mastectomy and immediate reconstruction, as well as lumpectomy and sentinel lymph node biopsy.

2. Why is this an important part of breast cancer care?

One of the issues is the adequacy of surgery. As lesions have become smaller and smaller it has become more and more appropriate to lessen the surgical procedure. We feel it is critical to avail all patients who are amenable to minimal surgery. In our hands the sentinel lymph node biopsy is a well proven technique and it spares the vast majority of women from an axillary dissection. The importance of that is the axillary dissection is where the majority of morbidity associated with breast cancer lies.

For certain women who are high risk or otherwise identified as having truly inherited breast cancer, mastectomy becomes an option. This is really a small subset of the population. In those patients, with the skin sparing technique along with immediate reconstruction we can achieve excellent cosmetics results to the point where it is difficult to see that she had a prior procedure.

3. How is this different then what might be offered in the community (outside of UC Irvine )?

We are at the forefront of imaging technology with specialized MRI and Laser studies. We are able to truly identify the extent of tumor and also rule out the possibility of additional tumor sites in the breast.

4. What will my (the patient) experience be like?

At the time of consult, depending on the work-up she's received so far, we'll review all of the results. I will examine the patient and present her with options as to the management of her disease. If there is any indication she should be evaluated for neoadjuvant therapy (chemotherapy prior to surgery) or other types of therapy prior to surgery, we will arrange for that evaluation.

On the day of surgery I will see her preoperatively. The vast majority of surgery is done on an outpatient basis. This is done where the breast center, and more importantly, where the Imaging Center is located at the Cancer Center. In those situations where the lesion is non-palpable, the localizing procedure can be done in the same area and the patient can be immediately transferred to the preoperative holding area.

Everything is at one place, both imaging and surgery. If we need other consultations we can arrange for that right there. Medical oncology is on the same floor and radiation oncology is on the first floor of the same building. We also work hand-in-hand with the plastic surgery department where breast reconstruction is a particular strength.

5. What current studies, or novel options within your specialty are currently available?

We really have a robust program with the Beckman Laser Institute, which is a world class research institute looking at using lasers in a noninvasive way of identifying disease and also monitoring treatment effects.

For patients with early disease we're using the latest surgical techniques that minimize both the surgical incision and extent of the operation.

We really are utilizing the cutting edge technologies. We offer treatment programs which are recently developed and even more importantly, we are actually in the forefront of developing newer technologies in both the diagnosis and treatment of breast cancer.

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