Multi-disciplinary Care at Northwest Hospital

If you are facing a breast cancer diagnosis, you want confidence that your treatment plan is the best one possible. To ensure that each breast cancer patient of the Herman & Walter Samuelson Breast Care Center does, in fact, receive the best care, Northwest Hospital hosts monthly multi-disciplinary conferences that are connected to Sinai Hospital via teleconference.

These conferences are called “multi-disciplinary” because they consist of a meeting of doctors from different cancer specialties, including medical oncologists, radiation oncologists, surgeons, pathologists and endocrinologists. A genetic counselor, who can give insight into the chances a patient’s breast cancer will return after treatment, also attends.

Dawn Leonard, M.D., breast surgeon and medical director of the Samuelson Breast Care Center, leads the conferences. After she presents the details of a patient’s case, center radiologist Liba Goldblum, M.D., explains images of the patient’s tumors taken from mammography and breast MRI. Next, a pathologist goes over slides that show the molecular structure of the patient’s biopsied tumor. Finally, the specialists are invited to apply their specific areas of expertise to the case, and a dialogue about treatment ensues.

As each patient’s cancer diagnosis is as unique as that person is, the format is an effective way to make sure that no angle of a patient’s medical condition is left unexplored. Essentially, the monthly conferences give patients the benefit of “being seen” by a dozen or more physicians at the same time.

Through it all, patient privacy is protected. Only pertinent details are shared, such as age, ethnic background, medical history (especially history of breast cancer risk factors) and family history of breast or ovarian cancer. These are all factors that play into a patient’s breast cancer risk.

For patients who have a high chance of breast cancer returning after treatment, doctors may advise them to undergo a mastectomy – even if their breast cancer is at stage 0, the earliest it can be detected – to protect them from a future breast cancer diagnosis. The group of physicians will also make recommendations as to whether a patient should receive chemotherapy, drug therapy or radiation – and in what order. Finally, if a patient needs one or both breasts removed, the doctors will also discuss when and how breast reconstruction should be approached. Reconstruction is always viewed as part of the treatment for breast cancer so that, if she so desires, a woman can have back her original image as much as possible.

Finally, some of the cases handled at the conferences are particularly difficult, such as when the group considers a patient who has a stage 4, triple negative cancer diagnosis, which has a low survival rate. Given that some cancer treatments can be hard on some patients, how aggressively should such a cancer be treated? Is the treatment worse than the disease?

Sometimes the answers are best determined through a conversation between doctor and patient. However, the overall consensus of the cancer doctors is that the patient must always be given hope. Optimism is a powerful force in impacting a patient’s outcome, and, given hope, even some of the sickest patients move onto the road to recovery.
-Holly Hosler