A comprehensive approach to breast health requires the expertise of multiple specialized physicians. The specific doctor involved depends on the stage of the health journey, whether it is routine screening, confirming a diagnosis, or administering complex treatment. This multi-disciplinary network ensures every aspect of breast health is addressed by a professional with specific, advanced training.
Primary Care Providers and Initial Screening
The first point of contact for breast health maintenance is typically a Primary Care Provider (PCP), such as a general practitioner, family medicine physician, or obstetrician-gynecologist (OB-GYN). These physicians manage routine health and preventative care. They conduct regular Clinical Breast Exams (CBEs) during physicals to feel for any lumps or noticeable changes in the breast tissue.
PCPs and OB-GYNs determine a patient’s personalized risk factors, such as family history or genetic predispositions, which guides screening recommendations. Based on guidelines and individual risk, they issue referrals for initial screening procedures, most commonly mammograms. If an abnormality is found or reported, the PCP coordinates the next steps, ensuring a timely referral to diagnostic specialists.
Diagnostic Imaging and Pathology Specialists
Once an abnormality is identified, two distinct types of specialists work together to establish a definitive diagnosis. Breast Radiologists specialize in interpreting medical images, including mammograms, ultrasounds, and Magnetic Resonance Imaging (MRI) scans. They differentiate subtle signs of disease from normal tissue variations, often using 3D mammography for clearer visualization. Radiologists also perform minimally invasive, image-guided biopsies to collect a tissue sample from the suspicious area.
The collected tissue is sent to a Pathologist, who is responsible for the microscopic analysis of cells and tissues. Pathologists confirm whether the cells are benign or malignant, thereby diagnosing cancer. Their role extends beyond the initial diagnosis by characterizing the tumor’s specific biology, which dictates the course of treatment. They determine the cancer type, tumor grade (how aggressive the cells appear), and the status of hormone receptors (ER, PR, and HER2/neu). This analysis provides the treatment team with information to select targeted therapies.
Surgical and Definitive Treatment Experts
Following a cancer diagnosis, a Breast Surgeon or Surgical Oncologist directs the physical intervention. These surgeons perform procedures ranging from excisional biopsies to remove small lesions to larger operations like lumpectomies or mastectomies. A lumpectomy, or breast-conserving surgery, removes cancerous tissue along with a margin of healthy tissue. If the entire breast must be removed, the surgeon performs a mastectomy and manages the removal of lymph nodes, such as a sentinel lymph node biopsy, to determine if the cancer has spread.
Breast Surgeons coordinate closely with Plastic Surgeons, who are responsible for breast reconstruction procedures performed either immediately following the mastectomy or at a later date. The surgical oncologist guides the patient through the initial stages of treatment and coordinates care with other specialists on the multi-disciplinary team.
Non-Surgical Cancer Management
For treatments that do not involve physical removal, two types of oncologists administer systemic and localized therapies. The Medical Oncologist manages drug-based treatments designed to target cancer cells throughout the body. This includes prescribing chemotherapy to kill rapidly dividing cells, and hormonal therapy, which blocks the effects of hormones on hormone-receptor-positive cancers.
Medical oncologists also administer targeted therapies and immunotherapy, utilizing drugs that attack cancer cells with specific genetic markers, such as HER2 status. The Radiation Oncologist specializes in the therapeutic use of high-energy radiation to destroy cancer cells. Radiation is typically applied after a lumpectomy to reduce the risk of local recurrence. They meticulously plan the radiation dose and delivery method, such as external beam radiation, to target the specific area while minimizing damage to surrounding healthy organs.