About Breast Cancer

What to look for in choosing a breast center and a breast cancer specialist

A woman who is diagnosed with breast cancer typically talks with a radiologist, a pathologist, a breast surgeon, and an oncologist to determine what her treatment plan should be.

She will try to weigh the options between often conflicting advice from several doctors without the benefit of a team of experts who are working together to devise the best treatment plan.

At SCCA. we recommend choosing a center that uses a team approach -- where the oncologist, radiologist, surgeon, pathologist, and anyone else involved meets to discuss each woman's case and determine the best treatment plan for her.

A breast program must address a patient's emotional, psychological, and educational needs, as well as her physical needs. A patient who has information about her disease and treatment options and is well supported emotionally is in the best position to be an effective partner in her health-care decisions.

Early, accurate diagnosis of breast cancer is probably as important to a woman's survival as any element of treatment. This is done by radiologists (doctors who take and read images, typically mammograms, of the breast) and pathologists (doctors who analyze cells and tissue to tell whether they are benign or malignant). The more experience a practitioner has with a procedure, the better. Reading mammograms and analyzing biopsy tissue is a difficult and subtle task, involving as much art as science.

This is one of the reasons large cancer centers, whose doctors treat thousands of people a year, are better places to get good, complete cancer care.

Attributes of an Excellent Breast Center

Team Breast Conference for Every Patient All the specialists involved meet to discuss the care of each patient before treatment. Ideally, the patient is present at this meeting, so she can discuss her life priorities and care preferences.

Comprehensive Care The center should offer as many breast services as possible, from radiology to reconstructive surgery. This enables the specialists and staff to work as a team and effectively coordinate care.

Specialized Radiology A dedicated breast-imaging center is likely to provide better screening than an all-purpose radiologist.

State-of-the-Art Technology A center should have FDA-accredited mammography, breast ultrasound, stereotactic biopsy, and ABBI (advanced breast biopsy instrumentation) systems.

Coordinated Care Each patient should be tracked by one staff person who will be available to answer questions.

Research and Clinical Trials Doing research on new therapies is a good indication that the center is committed to pushing the envelope of available care.

Access to a Genetics Counselor Women with a family history of breast cancer may want to know about risk factors and the implications of genetic testing, even if they have no signs of disease.

Comfortable Treatment Area Ask for a tour of the center's chemotherapy treatment area. Is the atmosphere frightening or comforting? Are there extra chairs for family and friends?

Quick Response If you have symptoms, a breast center should not simply do your mammogram and send you home. If a first mammogram indicates the need for further screening, you would probably prefer to wait 30 minutes for the results and then continue testing rather than being sent home to return another day for your results.

Surgical Specialist Surgeons who call themselves breast surgeons should perform at least 90 percent of their operations on the breast. Ask. Too many general surgeons now call themselves breast surgeons, but only experience builds expertise.

Patient Comfort A biopsy can cause anxiety. Check if the center offers some form of sedation during the procedure.

Quick Consultation You should be able to ask a radiologist to explain any irregularities on your mammogram as soon as an interpretation is available.

On-site Counseling and Support Groups These include breast cancer survivor groups and groups for women at high risk for breast cancer. Sessions should be led by counselors who specialize in treating women with breast concerns.

A Patient Advocacy System A quality center assists women in dealing with physicians, insurance, and emotional needs. Sometimes the support may be provided by a nurse who accompanies patients to appointments.

Resource Center This should house books and videos, and have Internet access and staff trained to help you research medical literature.

Patient-Friendly Procedures Policies should be set for the convenience of the patient, not the hospital staff. Ask about private dressing rooms and waiting areas separate from the breast center's main lobby so patients in hospital gowns are not required to sit with fully dressed patients. Are there private lockers?

Sensitive Staff Trained in Dealing with Women with Breast Concerns A nurse or radiology technician who is sensitive to a woman's fears and needs can help make a mammogram or other procedure much less stressful.

 

August 2007