What makes one a Breast Specialist??

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J9W
J9W Member Posts: 395
edited June 2014 in Recommend Your Resources

Just wondering what qualifications, if any, allows a doctor to be called a 'breast specialist'? And how important is it to have someone with that designation?

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  • Beesie
    Beesie Member Posts: 12,240
    edited March 2014

    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.

  • sarahjane7374
    sarahjane7374 Member Posts: 669
    edited March 2014

    My BS is a general surgeon, specializing in treatment and management of breast cancer and breast disease.   He completed a fellowship in surgical oncology of the breast at the hospital where he now practices, and I believe he does that type of surgery exclusively.  The Breast Health Center/Program in Women's Oncology that I go to is part of the hospital's Department of OB/GYN. It is a teaching hospital for an Ivy League university.  I think it's extremely important to see someone who has training, experience and focus on breast cancer and other issues of the breast.  Extremely.

  • J9W
    J9W Member Posts: 395
    edited March 2014

    Thank you both for answering. I asked because my doctor has taken a sabatical which I learned of when I called for an appointment yesterday. Now I have to find someone else and want to make sure I get someone qualified. Sarahjane73, I'm in North Forida but grew up just outside of Boston and right now I wish I still lived up that way!  Beesie, thanks for that info, it's given me direction on how to check out the local doctors.

    I've had a 'some thing just doesn't feel right' feeling for a few months but of course, come up with all reasons that it's nothing serious.  So, I finally bite the bullet and try to see my doc only to find out she is gone for a while. :(  Ugh.

  • leaf
    leaf Member Posts: 8,188
    edited March 2014

    I thought that it was within the scope of practice of any MD to do surgery (in the USA).

    The practice of medicine includes the
    diagnosis, treatment, correction, advisement, or prescription for any
    human disease, ailment, injury, infirmity, deformity, pain, or other
    condition, physical or mental, real or imaginary.....

    Certification: MDs who wish to
    specialize must complete an additional 3 - 9 years of postgraduate work
    in their specialty area, then pass board certification examinations.
    Doctors who claim to practice in one specialty should be board-certified
    in that specific area of practice. <emphasis mine>

    http://www.nlm.nih.gov/medlineplus/ency/article/00...    

    So, I think a general practitioner can legally do breast surgery, or brain surgery for that matter. (Not that I would want one to do so.) They may not be able to get privileges to operate in an operating room if the hospital doesn't give them privileges.  If they can convince the patient to do the procedure, I think  they can legally.  When I was looking into this about 15 years ago, some dental surgeons apparently did jaw/maxillofacial  surgeries in their office, and some of these procedures can last for 8 or more hours.

  • Linda-n3
    Linda-n3 Member Posts: 2,439
    edited March 2014

    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.

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