Why this surgeon challenges overuse of cancer screenings, but spends hours with patients

Laura Esserman, MD, a breast cancer surgeon at University of California, San Francisco, is a proponent of cutting down on overutilization in oncology — yet she is known to spend hours with individual patients, according to The New York Times profile featuring her work.

Dr. Esserman believes breast cancer screenings can create overdiagnosis and overtreatment of cancers, in particular a condition called ductal carcinoma in situ. This condition is nearly always treated with surgery and radiation because it can precede invasive cancer, but Dr. Esserman believes this is not necessary, according to the report.

Her opinion is not popular, unsurprisingly, but a recent study published in JAMA Oncology supports her view, according to The New York Times. The study found treatment for the DCIS condition may not change outcomes.

For these reasons, Dr. Esserman is one of a handful of surgeons in the country who puts DCIS patients on active surveillance, rather than automatically performing surgery, according to the report. She believes in waiting to confirm surgery is needed rather than performing just-in-case lumpectomies, biopsies or mastectomies.

On the flipside, not being quick to jump into potentially unnecessary treatment means Dr. Esserman spends quite a bit of time with patients, making sure they understand why. She often stays in the office until 10 p.m., according to the report, or calls patients over her own dinner to talk, according to the report. Her tendency toward low-utilization is tempered by high patient-physician face time.

Read the full report here.


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