Choosing a doctor to treat your breast cancer may be one of the most important decisions you will ever make. Your primary care doctor may refer you to one or more specialists. These doctors often work together as a team.
Your chances for getting the best possible care are highest if all your health care professionals get involved at the beginning, when you're diagnosed, so everyone can get on the same page and work together as a team.
Specialists and Board Certification
Specialists are doctors who have trained in a specific area of medicine. After finishing the training for their specialty, they must pass an exam given by the specialty board. Doctors who pass the national board exams become board-certified specialists. Doctors who have not completed the specialty board exam are "board-eligible" but are not specialists.
Board certification is a sign that a doctor is highly trained in their field. Several fields related to cancer care have national boards that set standards that doctors must meet in order to be certified.
But some of the specialties that are important in cancer treatment don’t have board certifications. Doctors who practice in these specialties are board-certified in a broader field. For example, there is no board certification for breast cancer surgery. Surgeons performing breast cancer surgery should be board-certified in general surgery, which gives them the basic skills to perform breast surgery.
If doctors practice in specialties that do not have national boards, additional training such as fellowships and years of experience are usually good measures of their qualifications.
Some specialists can subspecialize by completing more training in a particular area. They can sometimes become board-certified in the subspecialty, too.
Breast Cancer Specialists
Medical oncologist. A doctor who specializes in the medical treatment of cancer. Medical oncologists have a thorough knowledge of how cancers behave and grow and how to use medication to treat them. They also figure out the risk of the breast cancer coming back, as well as the need for more treatments (such as chemotherapy, hormonal therapy, or radiation therapy).
The medical oncologist manages your overall medical care for cancer and monitors your health during your treatment. They check your progress often, review your lab and X-ray results, and coordinate your medical care before and after your treatment.
Surgical oncologist. A doctor who specializes in the surgical treatment of cancer. Surgical oncologists do biopsies and other procedures such as removing a lump or a breast. These doctors have completed general surgery training and have received additional training in surgical oncology.
Breast surgeon. A doctor who specializes in the surgical removal of breast tumors and lymph nodes while saving as much of the breast as possible. These doctors may also do biopsies to diagnose or treat cancer.
Plastic surgeon. A surgeon who specializes in breast reconstruction.
Radiologist. A doctor trained in reading X-rays, CT scans, MRIs, ultrasounds, and other forms of imaging that look into the body.
Pathologist. A doctor who checks tissue samples under a microscope. They decide whether cancer is present, its size, whether the surgery removed all the cancer, and how many lymph nodes have cancer, if any.
Radiation oncologist. A doctor trained in treating cancer with radiation.
Other health care professionals that may be involved in your breast cancer treatment include:
- Oncology nurses who have special skills and pass a certifying test
- Radiation technologist who helps put you in the correct treatment position and delivers the proper radiation dose to the site
- Radiation physicist who helps plan the radiation dosage and treatment field to make it as safe as possible
How Do I Find a Specialist?
Your regular doctor is a good first source. They can give you a referral. They should know from experience who the most appropriate cancer specialists are in your area.
You can also search online. Check reliable websites such as the American College of Surgeons or the American Society of Clinical Oncology. You can also look on the websites of universities, medical schools, or the federal government.
The American Board of Medical Specialties publishes The Official ABMS Directory of Board Certified Medical Specialists. This lists a specialist's name, education, and specialty field. You can buy the directory, but it's also available at no charge through www.abms.org and at most public libraries.
Hospitals offer free and confidential telephone or online referral services for finding doctors. They give you information about a doctor's professional background.
Insurance companies can also give you names of cancer specialists along with referral requirements.
Once you have the names of a few candidates, find out:
- How many procedures or cases the doctor has been involved with
- The doctor's areas of special interest or research
- Which hospitals the doctor is affiliated with
- Whether the doctor is board-certified in the area of specialization
- Any fellowships they’ve done in cancer care (surgery, radiation therapy, medical oncology)
- Where the doctor was trained
If you can’t find the information, call the doctor’s office and ask some questions.
Choosing a Hospital to Treat Breast Cancer
When deciding on a breast cancer treatment facility, you should learn:
- Whether the hospital has experience in treating your condition
- If your health insurance covers care at the hospital
- If the hospital is conveniently located
- How the hospital was rated by outside organizations (such as the American College of Surgeons or the Joint Commission on Accreditation of Healthcare Organizations)
- If the hospital offers educational and social programs for cancer patients
- Whether the hospital is involved with cancer research and offers clinical trials
NCI Cancer Centers
The National Cancer Institute (NCI) is a branch of the federal government that has designated a select group of more than 60 medical institutions in over 30 states as cancer centers.
The highest rating is a National Cancer Institute-designated "comprehensive cancer center," which is generally associated with larger medical institutions, universities, or medical schools. They offer the latest in medications, new techniques, state-of-the-art equipment, and access to clinical trials. Their doctors stay up to date in the newest methods in treating cancer.
Call the Cancer Information Service at 800-4-CANCER (800-422-6237) between 9 a.m. and 4:30 p.m. ET Monday through Friday for more information about cancer treatment centers in your area.
For a list of cancer centers online, go to cancer.gov.
Choosing Your Support for Breast Cancer
It's important not to neglect your emotional health during cancer treatment. Not just you, but your family, friends, and caregivers will need support in varying ways during this difficult time.
- Cancer doctors or nurses can direct you or family members to a social worker familiar with support groups or individual support.
- An oncology social worker may be available to meet with you or your family to address emotional issues, financial difficulties, insurance questions, discharge planning, transportation, and home or hospice care.
- Hospitals organize seminars or programs that educate people about cancer, provide support, and offer walk-a-thons and other activities for women with cancer.
- A dietitian can offer ways to make meals more nutritious and appealing.
- A psychologist can address more serious emotional challenges such as depression or anxiety, which are common in cancer patients.
- A hospital chaplain uses spiritual and clinical training to meet the spiritual needs of people with cancer and their families.
- Hospitals often have libraries or resource centers with information about cancer.
Online Breast Cancer Resources
There are thousands of websites that offer information and advice. Some are reliable and concise, but others can be misleading or even dangerous.
- Seek out reputable websites -- those run by agencies of the U.S. government, such as the National Cancer Institute, or by an organization you know about, such as the American Cancer Society -- that offer current and reliable information.
- Avoid websites or chat rooms that offer "miracle cures" or try to persuade patients to try methods that sound too good to be true.
- Be careful when giving out personal information online.
Your treatment will be less stressful and easier to manage when you have a team that’s right for you and the support you need.