Selecting a doctor to treat your breast cancer may be one of the
most important decisions you will ever make. Your primary care
physician may refer you to one or more specialists. These
specialists include surgeons, medical oncologists, plastic
surgeons, and radiation oncologists. These doctors often work
together as a team.
Why do I need so many doctors?
If you are diagnosed
with breast cancer, your chances for getting the best possible
results are greatest when you're first diagnosed. Because of
this, it's very important that all cancer specialists
involved in your diagnosis and treatment participate in discussions
that will determine the strategy for your breast cancer care.
What is a specialist?
Specialists are doctors who
have completed their residency training in a specific area of
medicine. After finishing the education and training needed for
their specialty, they must pass an examination given by the
specialty board. Doctors who meet all of the requirements for their
specialty and pass the national board exams are given the status of
"diplomate." They are now board-certified specialists in their
fields. Doctors who have not completed the specialty board
examination are "board-eligible," but are not yet specialists.
A specialist can become a subspecialist, as well. To do this,
the doctor must take at least one additional year of full-time
education in a particular area of a specialty. He or she can then
become board-certified in the subspecialty, too.
Should I look for a board-certified cancer
specialist?
Board certification, or the international
equivalent, is a sign that a doctor is highly trained in his or her
field. Several fields related to cancer care have national boards
that are responsible for setting standards that doctors must meet
in order to be certified. However, board certification does not
exist for some of the specialties that are important in cancer
treatment. Doctors who practice in these specialties are
board-certified in a broader field. For example, no board
certification exists for breast cancer surgery. Surgeons performing
these procedures, however, should be board-certified in general
surgery, which gives them the basic skills needed to perform breast
surgery.
If physicians practice in specialties that do not have national
boards, additional training, such as fellowships and years of
experience related to cancer diagnosis and treatment, are usually
good measures of their qualifications.
What does each specialist do?
A number of doctors
will play a role in your breast cancer treatment. The following
lists who may be involved and what they are responsible for:
- Medical oncologist - A physician who specializes
in the medical treatment of cancer. Medical oncologists have a
thorough knowledge of how cancers behave and grow. This knowledge
is used to calculate your risk of recurrence as well as the
possible need for and benefits of additional or adjuvant therapy
(such as chemotherapy, hormonal therapy, or bone marrow
transplantation). Your medical oncologist generally manages your
overall medical care and monitors your general health during your
course of treatment. He or she checks your progress frequently,
reviews your lab and X-ray results, and coordinates your medical
care before and after your course of treatment.
- Breast surgeons - Physicians who specialize in the
surgical removal of breast tumors while conserving as much of the
breast as possible
- Surgical oncologist- A doctor who performs
biopsies and other surgical procedures such as removing a lump or a
breast
- Plastic surgeons - Surgeons who specialize in
state-of-the-art breast reconstructive techniques
- Radiation oncologist - A staff physician trained
in cancer treatment using radiation therapy
In addition to specialists, other medical professionals may be
involved in your breast cancer treatment, including:
- Radiation therapist - A professional who helps
place you in the correct treatment position and interprets X-ray
studies
- Radiation technologist - A professional who checks
the radiation dosage to make it as safe as possible
How do I go about finding a specialist?
Your primary
care doctor can refer you to a specialist. You can also get the
names of specialists from a medical society, your local hospitals,
and from medical schools. In addition, the American Board of
Medical Specialties (www.abms.org)
publishes the Official ABMS
Directory of Board-Certified Medical Specialists. This
publication lists a specialist's name, education, and
specialty field. The directory can be purchased, but it is also
available at no charge at most public libraries.