Your Doctor's Treatment Plan Is Key for Success
 For the best results after breast cancer treatment, look to your doctor. The treatment decisions he or she makes appear to have a large impact on whether the cancer returns.
A new study that looked at the medical records of nearly 1,000 women who had ductal carcinoma in situ, the most common type of noninvasive breast cancer, found that treatment varied widely.
And those variations in treatment might have brought on about a third of cancer recurrence.
The best treatment, the researchers say, includes surgery that removes enough tissue that no cancer cells are found at the tissue's edge. This is called a "negative margin." The best treatment also involves radiation therapy as a follow-up to cancer surgery - to ensure that any cancer cells that might have been left in the body are destroyed.
But not all surgeons chose this plan of treatment. Although the researchers expected some variation in treatment plans - in part, because of the women's treatment preferences - they didn't anticipate the scope of variation.
These variations had an impact even after looking at other aspects of the cancer - how large the tumor was and how advanced the cancer was. The variation in treatments accounted for 15 to 35 percent of cancer occurring in the opposite breast in the five years after surgery and 13 to 30 percent of cancer returning within 10 years.
What can a woman do?
“Be involved in your care” said Beth Horenkamp, MD of Hematology/Oncology Medical Specialists (HOMS), of Lancaster General Health.
Dr. Horenkamp advises her patients to write down any questions they have and make sure they ask the questions. "It is extremely important that the patients understand any choices they have for treatment," she said.
Ask your surgeon how many procedures he or she does, with more being better, says Beth Virnig at the University of Minnesota.
And, she says, many studies, but not all, show teaching institutions are better when it comes to breast cancer treatments.
Another expert urges women diagnosed with breast cancer to find out their doctor's views on the importance of negative margins during surgery and radiation therapy afterward.
Always talk with your health care provider to find out more information.
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