Why should you choose a Fellowship-trained Breast Surgeon for your breast care?

Studies from the United States have shown up to a 36% reduction in the risk of dying from breast cancer at 5 years if the patient is treated by a surgeon with specialty training in breast cancer (1-3).

Other studies from the United States have shown that having a surgeon that has undergone specialization in breast surgery is associated with a 26% higher rate of breast conserving surgery (i.e. surgery that allows a woman to keep her breast) rather than opting for mastectomy (4,5).

Another study from the United Kingdom showed that survival from breast cancer was 20% worse when the patients were not treated by a breast “specialist”. (6)

These findings underscore the importance of specialty training in the management of breast disease. (7)

Nowadays, breast surgery is not just about lumpectomy versus mastectomy. New surgical techniques such as nipple-sparing mastectomy with its superior cosmetic result have become important options to be able to offer patients, especially in the context of prophylactic or risk-reducing surgery.

Additionally, the management of breast cancer has become increasingly complex, including decisions on neoadjuvant chemotherapy, timing of surgery and breast reconstruction viz-a-viz radiation, and the nuances of treating the axilla (armpit). The breast surgeon has to be armed with the most current knowledge of breast cancer management to be able to offer the best care to the breast cancer patient.

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References

1. Skinner KA, Helsper JT, Deapen D, et al. Breast cancer: do specialists make a difference? Ann Surg Oncol 2003; 10:606–15 [PubMed]
2. Gillis CR, Hole DJ. Survival outcome of care by specialist surgeons in breast cancer: a study of 3786 patients in the west of Scotland. BMJ 1996; 312:145–8 [PubMed]
3. Golledge J, Wiggins JE, Callam MJ. Effect of surgical subspecialization on breast cancer outcome. Br J Surg 2000; 87:1420–5 [PubMed]
4. Hiotis K, Ye W, Sposto R, et al. Predictors of breast conservation therapy: size is not all that matters. Cancer 2005; 103:892–9 [PubMed]
5. Rosenbaum Smith SM, Osborne MP. Screening for breast cancer. In: Cameron JL ed. Current Surgical Therapy. Mosby; 2007:693–6
6. Kingsmore D, Hole D, Gillis C. Why does specialist treatment of breast cancer improve survival? The role of surgical management. Br J Cancer 90; 1920–5 [PubMed]
7. Pass HA, Klimberg SV, Copeland EM 3rd. Are “breast-focused” surgeons more competent? Ann Surg Oncol. 2008 Apr;15(4):953-5.
Daniel J Farrugia MD PhD Administrator
Director, Centegra Comprehensive Breast Program
Daniel Farrugia MD PhD is a fellowship-trained breast surgeon in the northern suburbs of Chicago. He is Director of the Centegra Comprehensive Breast Program. His research in breast cancer has been published in top international journals, and has been cited over a thousand times in the medical literature.
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