Your Breast Cancer Treatment Team
By Michael Russell
Today, the majority of breast cancers are diagnosed by mammography. There cancers are small, often too small to be felt and surgeons usually rely on radiologists to localize these small cancers with a hook wire or some injected dye. The technology has changed drastically and we have entered a new era of breast cancer diagnosis and treatment. Because of the many elements that come into play in breast cancer diagnosis and treatment, coordination is necessary among the team of physicians: surgeon, radiation oncologist, cancer pathologist, plastic surgeon, radiologist and medical oncologist.
Ideally, a woman with a recent diagnosis of breast cancer communicates with a primary physician who takes charge of developing a treatment plan with her and then coordinates its implementation. These team members can work at a single institution or be drawn from a wider geographic distribution and any of the cancer specialists can act as the coordinating physician. Often, it is the medical oncologist who coordinates the flow of information and treatment for the patient, but many surgeons and radiation oncologists take on this pivotal role as well.
It is important that breast cancer patients find a cancer specialist that she can communicate with and who will address her concerns. However, there are medical systems in which it may be difficult for the patient to connect with one physician who will act as her coordinating team leader. If you are in this situation, don't despair. You just need adequate information to get you the treatment you need and be your own team leader. It is possible to go through this process without a physician to spearhead your treatment plan and still get high quality health care.
The overall treatment plan revolves around two critical decisions. One deals with local control and the second with the need for systemic therapy. Often, cancer patients and their doctors cannot decide upon the issue of systemic therapy until all the information is available from the surgical procedure.
Since the diagnosis and treatment of breast cancer are done primarily on an outpatient basis, cancer patients may travel to various locations for different aspects of treatment. Some women may come to a breast cancer facility for the definitive surgery and then have radiotherapy at a facility closer to their home. If patients require various therapies, it is important to consider doing something similar in order to make treatment appointments as convenient as possible.
One of the key tools used in coordinating a woman's care is a treatment planning conference. This conference is a meeting of treatment team members to discuss the patient's case and to develop a coordinated treatment plan based on the patient's situation. The conference allows each of the team members to view a common history, the radiological breast images, the pathology report and pathology images. The patient is usually excluded from the treatment planning conference in order to allow an honest exchange of opinions between the team members. The treatment planning conference is very important in coordinating care. Each of the potentially treating physicians can, in one setting, agree on an overall treatment plan and their particular contribution to that plan. This united approach also guarantees that the physicians line up the sequencing of the different therapies correctly and in the manner that is most beneficial to the cancer patient.
Besides benefiting the woman with breast cancer, the nature of the conference itself promotes education and understanding on the part of various physicians involved. Women diagnosed in the future stand to benefit greatly from the shared pool of information that these conferences provide medical professionals in general.
Michael Russell
Your Independent guide to Breast Cancer
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