New Research of Breast Cancer: the Importance of Surgeon

Aug 12, 2011 by Alexander

Surgeons are more important than the treatment itself.
American “Newsweek” reported that, according to a new study conducted by the United States, breast cancer treatment because of the surgeon’s skills vary significantly different. According to the researchers estimated that if all the surgeon to achieve negative margins in radiotherapy technical and implementation of medium to achieve the level of patient risk of recurrence of cancer within 5 years will be reduced 22% more surprising is that the surgeon’s important sex may even be more than the treatment itself.

Difficult to find the doctor say

For any women who received breast cancer surgery, in recovery room, they want to hear the most is “we have completely removed the tumor.” In other words, negative margins. The so-called negative margin is cut off the edge of a few millimeters within the organization does not have any cancer cells that can reduce the likelihood of recurrence of breast cancer, thereby increasing the chances of survival of patients. In addition, breast cancer or other breast-conserving surgery received radiation therapy after surgery can also improve the cancer-free survival.

However, breast cancer patients in order to find a skilled surgeon, the surgery is not easy for themselves. As the “Newsweek” in 2009, a report pointed out, the ideal breast cancer patients seeking treatment in the course of many years is the difficulty faced by a major scandal. A new study found that for patients with ductal carcinoma in situ, treatment is difficult to get a good threat than anyone’s imagination, which is a major obstacle to professional medical organizations and medical insurance department refused to release information. In addition, the surgeon’s professional conduct in different ways, some people do not take into account the patient’s economic capacity, and even the existence of moral issues.

Negative margins radiotherapy = low risk of relapse

Non-invasive breast cancer, usually breast-conserving surgery or mastectomy treatment, patients undergoing breast-conserving surgery received radiation therapy may or may not accept this treatment. According to “National Cancer Institute” (JNCI) 1 月 3 of a paper published today, the same treatment which depends on the surgeon for the surgery patients.

According to the U.S. Rand Corporation’s Andrew Dick is responsible for an analysis of intraductal breast cancer patients to prevent relapse after treatment in the two most important factors is negative tumor margins after breast conserving surgery and radiotherapy. Just how important these two factors? According to the researchers of the 994 patients with ductal carcinoma in situ analysis of medical records, breast-conserving surgery in women receiving radiotherapy after the cancer risk of recurrence in about 5%, while the women did not receive radiation therapy is as high as 14% achieve negative cuttingmargin while women receiving radiotherapy at about 3% risk of recurrence, positive surgical margin while women receiving radiation risk of recurrence is about 15%, to achieve negative margins did not receive radiotherapy the risk of recurrence in women around 13%, positive margins at the same time not women receiving radiotherapy the risk of recurrence is as high as 25%.

Obviously, did not receive radiation therapy after surgery will increase the risk of breast cancer recurrence, positive margins will also have this adverse effect. More surprising is that these two factors will determine the treatment effect due to different surgeons and there are significant differences. Difference in the end be? According to the researchers estimated that if all the surgeon to achieve negative margins in radiotherapy technical and implementation of medium to achieve the level of patient risk of recurrence of cancer within 5 years will be reduced 22%.

Treatment is more important than a doctor or

The researchers pointed out: “treatment by different surgeons there are obvious technical differences and technical differences between the surgeon’s effect on long-term treatment is a vexing problem, this can not explain the difference to the treatment of an important impact on results. ”

For patients, their doctors difficult to understand how to implement their own treatment. Together with the paper in an editorial published in the University of Minnesota epidemiologist 贝丝沃尼格 and Todd Tuttle surgeon to make such a question – if that surgeons can lead to differences in treatment rate of 35%, how should women choose surgery doctors? This choice is not easy. Wo Nige said, patients are unable to obtain relevant information, more surprising is that the surgeon may even exceed the importance of the treatment itself. She said: “If a doctor is for patients with breast-conserving surgery, another doctor for the implementation of mastectomy patients, former patients bring to treatment may be superior to the latter, although in normal circumstances to accept mastectomy a higher survival rate in patients without cancer. ”

Still waiting for information disclosure

Wo Nige pointed out, a surgeon to help patients choose the ideal way is to implement all the surgeons announced the number of breast cancer surgery. But for anyone, sorting out this information is a daunting task. U.S. health insurance department refused to open Dr. Ren Heyu treatment of specific diseases, the number of cases and the amount of information about the surgery. Non-profit organization Consumers “Checkbook tried to get health insurance department released the information, but in 2009 the court battle, this request was ultimately turned down in 2010,” Newsweek “has tried to convince the American Society of Clinical Oncology patients to establish a database to provide members of the Association over the past few years, the number of cases of cancer-specific treatment, whether through professional certification, with a long clinical experience and other information. “Newsweek” with a few months to consult with the Society of Clinical Oncology, finally turned away.

On this issue, “Consumer Reports” of the publisher of Consumers Union made a major breakthrough. Consumers Union’s John Santa on the “Newsweek” that in 2010, they succeeded in persuading Society of Thoracic Surgeons published some critical information, including a 30-day mortality, severe infection and other complications, the surgery number and whether the patient received appropriate medication. In order to convince the Society of Thoracic Surgeons published the information, they work a full two years. But in its 950 member group (where “group” represents one or several surgeons), only 221 groups agree to publish their data.

Published in the government or medical institution before the doctor’s information, the patient will remain in darkness. For cancer surgery, the current database is the best by the American College of Surgeons Commission on Cancer finishing to create a database. Into the database and select the “Details”, you can see a specific city, state or Zip code and other information, and found near the cancer treatment institutions and their surgical treatment each year through the different stages of cancer types and number of cases. Understand the information, at least not for those who were never treated for his own cancer doctor for the implementation of treatment. But the database still can not provide the information patients want most, namely in the choice of the surgeon before the cancer treatment they need to know all the information.