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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.
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