Progress ReportDivision & Section Reports
Sheldon Marc Feldman, MD
Today, we are in a new era of breast cancer treatment. We are providing a high standard of care by integrating all aspects of breast cancer treatment, including superior diagnostics, surgeons who are devoted exclusively to breast surgery, and in-depth counseling and support programs.
Our approach is multidisciplinary. We address each patient by coordinating the expertise of surgeons, medical oncologists, radiation oncologists, mammographers, radiologists, pathologists, psychiatrists and genetic counselors. Every week, we convene a meetingthe mammography and pathology conferencethat brings all of these disciplines together. Our radiologists and pathologists make particularly valuable contributions by helping to reduce unnecessary biopsies and identify breast cancer patients who are candidates for breast conservation.
We are approaching the field of hereditary breast cancer through three interrelated programs: a new Division of Genetics, a psychiatric support program for women who have had breast cancer or are at substantial risk, and our initial program in this area, Women At Risk (WAR) which we started in 1991.
The most recent of these programs is the Division of Genetics within the Division of Breast Surgery. We are actively involved with research into the two known genes for breast cancer, BRCA1 and BRCA2. This work is important for women with a strong family history of breast cancer. In support of these women, we are also proud of our liaison with the Department of Psychiatry. Two psychiatrists are available to provide counseling for women who have had breast cancer or who are at very high risk for developing it.
Our WAR program recognizes that those patients who are at high risk benefit from early intervention, including research, education, counseling and peer support. A wide-ranging program, WAR sponsors a monthly lecture series as well as an annual symposium on women's health issues. We also know that it's important for women who have been diagnosed with breast cancer to be able to seek out information about the disease. To respond to that need, WAR's patient library provides extensive materials on breast cancer, including Internet access. The library is staffed by breast cancer survivorsa positive image for those who have just been diagnosed. Within WAR, SHARE is a network of breast cancer survivors who provide peer group support. The library may be found at both the Herbert Irving Pavilion and 16 East 60th Street sites.
Our interdisciplinary approach has also had an impact on the teaching aspect of the division because our residents are involved with a wide range of medical specialties. In the past, the training was more unidimensional; the focus was on surgery. Today, our approach results in not only better clinical care, but a richer experience for our residents. This demonstrates meaningfully that treating a disease is a multidisciplinary art. In breast surgery, we believe that this approach is a leading-edge model for effective teaching.
I am honored and excited to have been appointed Acting Chief of the Breast Service at Columbia University Medical Center.
Division of Breast Surgery