What makes one a Breast Specialist??

I think it's important to differentiate between a Breast Specialist (the title) and a breast specialist (someone with the expertise).  

Breast Surgeons/Breast Specialist are general surgeons. That's what they graduate as.  No one graduates as a "Breast Surgeon" or a "Breast Specialist". However, General Surgeons may choose to specialize in breast surgery.  They may focus their residency on breast surgery, or have a fellowship in breast surgery.  And they may focus their practice on breast surgery.  Those are things that would make them a "breast specialist". 

Some areas of specialty are board certified.  In other words, to use the "Specialist" title in these fields, the doctor must have a certain level of education and must meet the qualifications standards.  I might be wrong, but last time I checked (which was a number of years ago), there was no governing body determining who can call themselves a Breast Specialist - it is not, I believe, a board-certified specialty.  So this means that any doctor can choose to call himself or herself a Breast Specialist. 

Of course, most doctors who use the Breast Specialist title actually are breast specialists - they have the extra training in breast surgery and they focus their practice on breast surgery.  But not all do.  I've googled some doctors who call themselves Breast Specialists and I've been surprised to find that their CV shows no training in breast cancer surgery, and their practice seems to include all types of surgery.  On the other hand, my surgeon calls himself a General Surgeon - you never see the title Breast Specialist associated with his name - yet he focuses on breast cancer surgery and he is the head of breast cancer surgery at a major hospital.  So he truly is a breast specialist.

This website is interesting: the American Society of Breast Surgeons   The certification section talks about certifications for "in breast ultrasound and in stereotactic breast procedures".  There is a "Breast Surgeons Mastery of Breast Surgery" program but it's not a certification program.  It's "designed to help surgeons document their clinical performance of breast
procedures, as well as their care of breast cancer patients and
patients at risk for breast cancer."  

Interestingly, the website states that "The American Board of Surgery recognizes the
Mastery Program as fulfilling the requirements for Maintenance of
Certification (MOC) Part 4 (ongoing participation in a national,
regional or local surgical outcomes database or quality assessment
program.)"  But then when you go to The American Board of Surgery webpage on certifications, "Breast Specialist" or "Breast Surgeon" is not listed as a specialty.  

 The American Board of Surgery Maintenance of Certification (MOC) Overview    

When I click on the "Is Your Surgeon Certified" link at the bottom of the page, and then input my surgeon's name, he comes up as being certified in "Surgery" - with no reference to breast surgery. 

So my take on all of this is that it's important for someone with breast cancer to find themselves a breast specialist, but it doesn't matter if the doctor calls himself a Breast Specialist, or a General Surgeon, or a Surgical Oncologist, or anything else.  The title doesn't count since there is no official certification; the training and experience count.

It is true that a physician is "licensed" to "practice medicine and surgery." However, remember that surgery can include ANY procedure, such as repairing a skin laceration, removing a mole or skin tag, draining an abscess, all the way up to the more complicated and generally recognized procedures such as delivering babies, C-sections, brain surgery, orthopedic surgery, heart surgery, etc. So those "minor" procedures are still considered "surgery." Not all physicians are given hospital privileges to perform their procedures in the OR. In years past, many GPs (our family doc included) could deliver babies and do hernia repairs and appendectomies. In some areas of the world, and even some very underserved areas in the US, this is still the case, but in larger hospitals there are very stringent requirements to obtain privileges for surgery, for caring for special patient populations (pediatrics, ob/gyne, oncology, ICU, etc.).

Many physicians complete fellowships for 6 months to 2 years to specialize further, many of which do not have a specialty designation by the American Board of Medical Specialties, but some of which do. For example, breast surgeons may simply be general surgeons, they may simply focus on ONLY doing breast surgery (on the job training), some may have completed a fellowship with SUPERVISED training, but there is not a specialty listing from ABMS. Same thing with oncologists: they get trained in treating cancer, but then many specialize even further to hematology, or breast, or lung, or colon, or prostate ... but there is a lot of overlap, and there is knowledge and skill that are fundamental to ALL oncologists. 

J9W, you raised a great question, and we should really look at our providers' credentials AS WELL as their experience!

BTW, I know some plastic and cosmetic surgeons also do facelifts out of the hospital setting, and when something goes wrong, there is no backup - a friend of mine reacted badly to the drugs that the surgeon used during the procedure and ended up going from that office to the hospital in an ambulance, lucky to have properly trained team to keep her alive enroute and once she got there.