Breast cancer tests and surgery available on the local level

Over the past decade, the number of breast cancer surgeries performed in Pennsylvania have stayed relatively consistent.

That’s the word from the PA Health Care Cost Containment Council which provided statistics on breast cancer and surgery between 2008 and 2017 in honor of Breast Cancer Awareness Month observed in October.

In addition to sharing some of the statistics, The Era also reached out to two Bradford surgeons, Dr. Nathaniel Graham and Dr. Luis Gonzalez, who spoke on the availability of tests and surgery at the local level. Both surgeons have private practices, and practice at Bradford Regional Medical Center.

As for the data, the council states that in 2008 there were 11,233 breast cancer surgeries compared to 11,717 in 2017. In addition, 71 percent of the surgeries in 2017 were lumpectomies, compared to 60.5 percent in 2008.

The data also noted the breast cancer surgery rates per 10,000 female county residents in 2017. For example, in McKean County there were 37 breast cancer surgeries, compared to 74 in Clearfield County, 28 in Elk County, 27 in Tioga County and 27 in Warren County. Information on breast cancer surgeries in Cameron and Potter counties was not provided.

For his part, Graham, who has worked in the Bradford area the past 30 years, said his research and training were in needle localizations for nonpalpable breast lesions.

“Now we have a whole bunch of new tests the oncologists do of the specimen (such as) genetic testing as well as the usual hormone receptors,” Graham explained. “There’s a whole bunch of genetic tests that give us a whole new avenue to treat them with chemotherapy. When it comes down to the initial staging, what matters is the tumor type, the tumor size and nodes.”

Graham said that was all different more than 30 years ago.

“When I came (to Bradford) in ‘88 nobody in this county had anything less than a mastectomy for breast cancer,” he recalled. “I started breast conserving treatment in this county back in ‘88” which included lumpectomies and other procedures. He said also performed, and continues to do, reconstructive surgery for those who need or elect to have mastectomies.

“With the standard cancers of general surgery, colon cancer and breast cancer, those are things we basically offer here” at BRMC, Graham continued. “There’s nothing they do differently anywhere else. We do needle biopsies and we do image-guided biopsies” among other procedures.

Currently, Graham’s practice consists of 70 to 80 percent breast conserving treatment, which is non-mastectomy procedures.

Gonzalez echoed these comments, noting he, too, is able to provide surgery and refer his patients for chemotherapy and radiation in the area.

“The surgery hasn’t changed in almost 50 years, but the treatment has evolved quite a lot and is less aggressive than in it was in the past,” Gonzalez explained. “We’re capable and have a good (relationship) with the oncologist and the radiation oncologists people around here.”

Gonzalez said he welcomes second opinions on his diagnoses.

“From my point of view, I love second opinions because that makes the patient more comfortable and makes my decision more comfortable, too, “ he said. “Sometimes (the patient) makes the decision to stay here, even though they get a second opinion.”

Gonzalez noted that approximately 95 percent of the time he performs biopsies, and can make the diagnosis, in his office.

Gonzalez further noted that if a breast lump is detected, it becomes a priority in his office.

“If a person calls with an abnormal mammogram or a breast lump, they’ll be plugged in almost in the same week to be seen,” he remarked. “I know about the stress these women go through, the sooner we can take care of them, the better.”


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