Curing the Breast Cancer     Epidemic Right Now

Today's Date --  Oct 1,1998

MROZ-BAIER

BREAST CARE CLINIC

Christinel Mroz,MD,FACS

Curing the Breast Cancer Epidemic Right Now

Karen Stabiner, in her book To Dance With the Devil tells about the people and politics in the war against breast cancer. In the first chapter, the National Breast Cancer Coalition tries to stir enthusiasm for funding for breast cancer research by urging President Clinton to use the word "epidemic" in his speech on breast cancer. He didn’t use it, but Hillary did in her comments at a reception following that speech. Her efforts brought attention to the breast cancer problem and Congress did eventually fund additional millions of dollars to find a cure for breast cancer. That event occurred in 1993.

Despite all the efforts by the researchers, the billions of dollars spent, and all the awareness programs aired, the mortality rate of breast cancer has changed very little if at all. What else must be done to cure breast cancer?

First we must understand that breast cancer is a complicated disease. Not only are there ten different types of breast cancer but even the most common, infiltrating ductal carcinoma has various tumor grades and heterogeneous cell populations, each with its own genetics, receptors, and immunology. It is the opinion of the medical community that we will find a cure for breast cancer when we find a cure for all cancers.

Secondly, despite its complexity, there is one simple fact about breast cancer-early detection and proper treatment by physicians offers the best chance for survival. The survival rate of patients who are treated appropriately for tumors less that 1 cm in size approaches 98%. The way to cure breast cancer right now in 1998 is to educate, both medical professionals and the public, about breast self exam, screening mammography and the latest diagnostic techniques so that breast cancer can be diagnosed at its earliest stages. Medical students in Memphis do not receive any formal training in the diagnosis and treatment of breast problems. Without training there is no hope that these doctors can pass along the latest technique to their patients.

The Susan C. Komen Foundation provides funds nationally for research and locally to the Mroz-Baier Breast Care Clinic for educational programs. Dr. Christine Mroz, director of the clinic fully believes that many of the cancers she sees could be diagnosed earlier if breast care was practiced as a speciality. "Typically", she says ~~women experience fragmented breast care, moving from primary care doctors to

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Cont. Curing the Breast Cancer Epidemic Right Now

gynecologists to radiologists to surgeons back to radiologists, etc. This process often takes weeks of multiple appointments and prolonged the anxiety to find out what the breast problem is. "In such a haphazard approach to breast care, the patients may fall through the cracks and the diagnosis of breast cancer is delayed".

The breast specialist on the other hand takes the history, exams the patient, reviews the mammograms, and performs the ultrasound concurrently. That same physician then goes on to perform a biopsy, reviews the pathology, discusses treatment options, and performs cancer surgery when indicated. The breast specialist then coordinates follow up care for cancer patients with the oncologist, radiation therapist and reconstructive surgeon.

This concept of comprehensive coordinated breast care is practiced at the Mroz-Baier Breast Care Clinic. A grant from the Susan C. Komen Foundation helps educate regional physicians about comprehensive coordinated breast care. The grant helped sponsor fellowships for one hundred forty-two surgeons and radiologists. Education provided includes total breast care as well as training in latest diagnostic techniques including stereotactic breast biopsy and ultrasound.

Foundation funds also support the clinic in teaching residents in family practice, internal medicine, OB/ GYN, surgery and radiology in the full scope of breast care. Last year over thirty residents spent one to two week rotations at the Mroz-Baier Breast Care Clinic. They learned proper breast exam techniques, the importance of screening mammograms, the latest diagnostic techniques, and most importantly how to talk to women with breast problems and breast cancer. The goal of the educational grant is to   reach out to the next generation of physicians who will then fully understand what proper coordinated breast care is so their patients can reap the survival benefit of early detection and proper treatment.

The Foundation grant has also supported community outreach programs. Over five hundred women attended lectures at their church and employee or community groups, learning about the importance of breast self exam, screening mammography and what to demand as proper breast care. The Foundation grant has also provided funds for the technical component of diagnostic workups and breast biopsy for indigent patients who come to the clinic through its educational efforts. Last year over $14,000 of ultrasound, mammography, and stereotactic biopsy services were provided plus countless dollars of professional fees as well.

The Susan C. Komen Foundation and the Memphis Race for the Cure is to be congratulated for its constant work to raise funds to find cure for breast cancer. Not only will these funds help find a cure for breast cancer in the future but also provide day to day educational services promoting early detection, which is currently the only way to cure breast cancer.

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