Which doctors treat breast cancer?

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 are first diagnosed. Because of this, it is 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 sub-specialist, 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. Some breast surgeons have a special board certification in surgical oncology, however, which is a subspecialty area of cancer surgery expertise.

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 which doctors 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 or hormonal therapy). 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 surgeon: A surgeon who specializes in the surgical removal of breast tumors while conserving as much of the breast as possible
  • Surgical oncologist: A doctor who is trained in treating various cancers such as breast cancer, melanoma and sarcomas. The physician can perform biopsies and other surgical procedures, such as removing a lump or a breast.
  • Plastic surgeon: A surgeon who specializes in state-of-the-art breast reconstructive techniques
  • Radiation oncologist: A staff physician trained in cancer treatment using radiation therapy
  • Medical geneticist: A physician trained to evaluate the chance of each person having a genetic mutation which increases the risk for breast cancer. Risk assessment and counseling are usually involved at the initial visit.

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 breast cancer 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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