Breast-Conserving Surgery More Likely At Breast Centers
Main Category: Breast CancerAlso Included In: Cancer / Oncology
Article Date: 15 Sep 2008 - 3:00 PDT
Breast cancer patients are twice as likely to be offered breast-conserving surgery if treated by surgeons at breast centers than by surgeons in private practice, according to a national survey of breast specialists conducted by the American Society of Breast Disease. The survey presented a case study of a woman from her initial workup following a mammogram through diagnosis to surgical treatment. A full report of the case and survey responses of 118 clinicians is available in the Society's ASBD Advisor online at http://www.asbd.org.
According to Fayetteville, Arkansas breast surgeon, Michael Cross, MD, "this patient should be offered breast conservation, but genetic testing and counseling should be conducted early on as a full workup is performed."
When asked whether the patient should receive an MRI of the breast as part of the diagnostic process, nearly three-quarters of the physicians recommended an MRI. Of these, 50% recommended MRIs for all breast cancer patients and 50% requested the procedure based on the type of cancer that the patient in the case had. Dr. Cross, who provides a full commentary in the ASBD Advisor, offers that "all breast cancer patients should undergo bilateral breast MRI. An MRI is needed to properly stage the affected breast and assess for disease in the opposite breast."
Brian Englander, MD, director of imaging at the Pennsylvania Hospital in Philadelphia, notes that after appropriate treatment, "repeat bilateral MRI should be performed to evaluate for response to therapy and extent of residual disease prior to surgery."
The full article also reports on uses of chemotherapy and hormonal therapy prior to surgery as well as the kinds of surgical options and procedures that this woman might receive.
Visit the American Society of Breast Disease at http://www.asbd.org to download the full article.
About the American Society of Breast Disease
The American Society of Breast Disease is the leading professional medical society in the United States to serve all physicians and allied professionals committed to and advocating an interdisciplinary team approach to breast cancer and disease management, prevention, early detection, treatment, and research. The Society provides education programs and advocates for improvements in breast healthcare.
American Society of Breast Disease
Visit our breast cancer section for the latest news on this subject.
MLA
11 Feb. 2012. <http://www.medicalnewstoday.com/releases/121468.php>
APA
http://www.medicalnewstoday.com/releases/121468.php.
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Visitor Opinions In Chronological Order (1)
I Simply Don't Believe It.
posted by Gail Perry on 17 Sep 2008 at 1:52 pmI have run into so much bias against mastectomy and pro "breast conserving surgery" in the medical community that I simply don't believe that eligible candidates aren't being offered it. I did not go to a "breast center," and I was PRESSURED to have a lumpectomy.
I didn't want a lumpectomy. I did not want to do six weeks of radiation, five days a week. Why no one can get that this can be a rational choice is beyond me, but I am very glad that I made that choice.
I personally think it should be MANDATORY to do a breast MRI before a lumpectomy. What if there's an undetected tumor in another part of that breast? It's actually fairly common. I think it would be unconscionable to do a lumpectomy without an MRI to make as certain as possible that the tumor being removed is the only one in that breast.
I also believe it should be a bilateral MRI. Any medical person who doesn't "get" that is too focused on the statistics and not on the risk for that particular individual.
This may not hold true for inflammatory breast cancer. I don't know much about that type, but I know that for most breast cancers these things are crucial.
If I had a friend who was facing this, not only would I suggest they do this, but I would suggest they find another doctor if the doctor didn't want to do that MRI. As awful as the thought of having cancer in both breasts is, it's worse to think of doing a lumpectomy and missing some of the cancer in spite of getting clean margins around the tumor removed, or of not catching it in the other breast.
If MRI's delay surgery too much, then set up a "rapid test" system for women who have had a positive biopsy.
To me it's simple. Use these tests to save lives.
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