Week 5 Meichi

This week, I had the opportunity to shadow Dr. Newman during patient clinic visits. It was an insightful experience that allowed me to observe how clinical decisions are made and the important role that communication plays in guiding patients through their treatment journey.

Dr. Newman would explain the details of the patients' surgery options, thoroughly discussing the advantages and disadvantages of each choice. This included exploring the potential outcomes, risks, and the impact of each treatment on the patient's overall health and quality of life. Dr. Newman also provided her expert opinion on what she believed would be the most effective approach for each patient, ensuring that her recommendations were grounded in both clinical evidence and a deep understanding of the individual’s needs.

An essential part of the clinic visit was discussing the schedule arrangement for surgeries and treatments. Dr. Newman would carefully walk through the planned timeline with each patient, helping them feel more comfortable and confident in the treatment plan. This level of clarity and communication was invaluable in ensuring that the patients understood their treatment journey and felt supported at every stage.

I learned that there are three major concerns that need to be addressed in every breast cancer surgery, each of which plays a vital role in determining the most effective treatment plan for patients. The first concern is the tumor site itself. The location, type, and size of the tumor are crucial factors in deciding the type of surgery that is most appropriate and the plan for breast reconstruction. The second concern is the tissue surrounding the tumor, which may contain undetected cancer cells. In this case, mastectomy can address the issue effectively by removing a larger portion of tissue to ensure that all potential cancerous cells are excised. Lumpectomy, on the other hand, is typically followed by radiation therapy to target any remaining cancer cells in the breast. The third major concern is the metastasis of cancer cells, particularly the spread to lymph nodes, which can indicate that the cancer has begun to spread beyond the breast. To address this, a radioactive tracer is injected before surgery to help identify the sentinel lymph nodes—the first lymph nodes to which cancer is most likely to spread. During surgery, these nodes are removed through a small incision and examined for cancer cells through a biopsy. If cancer cells are detected, it may indicate that the cancer has spread, which can influence the subsequent course of treatment. In addition to these three primary concerns, genomic profiling of the patient has become an increasingly important factor in determining the appropriate treatment approach.