It was brought to my attention that an article ran in The New York Times on October 10 titled “Wanted: Mammologists.”
The article bemoaned the lack of doctors specializing in the treatment of breasts, and said we need “mammologists.” I Googled “mammologists” and guess what I found? Mammologists do actually exist!!! The American Society of Mammologists is an organization dedicated to promoting interest in the study of mammals. Somehow I didn’t believe that the OB-GYNs who wrote the piece meant that our medical system needs more experts who study warm-blooded creatures, many of which walk on all fours!
Unfortunately, the article falsely creates a fear that coordinated care for women with breast disease does not exist in the United States. The authors state: “The breast is something of an orphan in our health care system. We have cardiologists, nephrologists, hepatologists, proctologists and neurologists — but we have no ‘mammologists.’ How did the breast get lost?”
But the breast didn’t get lost!
What The New York Times article seems to be calling “mammologists” are what is known as breast surgeons in the United States. Breast Surgeons are the primary care physicians of the breasts.
I am a breast surgeon and I too desire seamless care for my patients. I can speak from personal experience, having created and opened the first hospital totally dedicated to the diagnosis and treatment of breast disease. Unfortunately the hospital closed in 2009— the patient care model was a huge success but the business model failed. The greatest lesson I learned from the experience was that the shared philosophical views of the breast surgeons, breast imagers, medical oncologists, radiation oncologists, plastic surgeons and other ancillary caregivers was far more important than a shared physical building! I still believe that comprehensive care in one facility is the way of the future, but I know that my patients receive the same level and quality of care even though they visit specialists in their independent offices.
The New York Times article goes on to state: “Women with breast cancer get lost in the mix, forced to make several different appointments, sit in various waiting rooms and see multiple doctors. In most cases, a woman with a breast problem will start with her obstetrician-gynecologist, who will then refer her to a surgeon (for a biopsy) or a radiologist (for a mammogram). The referring obstetrician-gynecologist may never see or hear from the patient again, and may not know if she kept her appointment or got adequate care.”
The gynecologists that refer their patients to my practice receive a faxed letter the day I bring their patient into my practice and every time I see that patient to keep them informed of the care plan. I perform the diagnostic biopsy, the definitive cancer surgery and coordinate their care with a team of specialists. The patients are far from lost and as a team we are with them on their journey. (For Dr. DuPree’s advice on "What to Do if You Find a Breast Lump or Have an Abnormal Mammogram," go here.)
The goal of a breast surgeon is to provide comprehensive and complete care to women and men with all aspects of breast disease from benign, non-cancerous disorders, to the most complex breast cancers. The roughly 240,000 women and men diagnosed with breast cancer annually are currently being care for by surgeons in the United States. General surgeons throughout the United States have completed at least five years of surgical training where diagnosis and treatment of breast disease is an integral part of their education. (Read the story of a patient who says Dr. DuPree saved her life by operating on her for free.)
The American Society of Breast Surgeons is an organization of 2800 surgeons throughout the United States and around the world who care for individuals with breast disease. Seventy percent of the members are general surgeons who provide care for breast disease as well as other surgical issues and 30 percent of the members are totally dedicated to the diagnosis and treatment of breast disease.