As if we didn’t already know that every doctor is different and have different opinions on the same issue..
Now, a new study of 994 women by the RAND Corp has found that how doctors choose to treat their breast cancer patients — and whether those treatment choices follow established recommendations — may play a larger role in whether a cancer returns than experts have believed.
In this new analysis of women with ductal carcinoma in situ, the most common type of noninvasive breast cancer, researchers found their treatment varied from surgeon to surgeon in a significant way and could account for up to 30 percent of recurrences!
“Treatment variation is a troubling but well-known phenomenon in health care,” said study author Andrew W. Dick, a researcher at RAND Corp. in Pittsburgh. The report is published online Jan. 3 and in the Jan. 19 print issue of the Journal of the National Cancer Institute. He added that he was surprised at how the variation is quite large and related to factors that are very important in health outcomes. Those factors include having “negative margins” — meaning that cancer cells are more than 2 millimeters away from the removed tissue’s edge — and getting radiation therapy after breast-conserving surgery.
The variation by surgeon in treatments accounted for 15 percent to 35 percent of cancer occurring in the opposite breast in the next five years and 13 percent to 30 percent of recurrences over 10 years, the study found.
So, the bottom line is how the patient does is due to their physician. Talk about playing God!
Of course, there is no simple way to guarantee that a woman will get the best possible doctor and treatment. One thing you can do is ask the surgeon how many procedures he or she has done. Also, women facing breast cancer should get their doctors’ views on radiation therapy after breast-conserving surgery and the importance of negative margins — both of which are associated with a lower risk of recurrence.