Top doctors: Diagnosing breast cancer

Name: Dr. Louis Potters Specialty:Chairman of the Department

Name: Dr. Louis Potters
Specialty:Chairman of the Department of Radiation Medicine at North Shore-LIJ Health System
Location:Manhasset
"Self-discovery of a breast lump likely represents the best 'save' for women diagnosed with breast cancer."
Click here to read, "Top doctors: Diagnosing Breast Cancer"
(Credit: Newsday/Audrey C. Tiernan)

Detecting breast cancer is no longer as simple -- or as imprecise -- as it used to be. Now, a suspicious mammogram may be followed by an ultrasound examination and then an MRI scan in a process designed to prevent unnecessary biopsies.

Here's what you should know about advances in diagnosing breast cancer:

1. EXAMS AND MAMMOGRAMS REMAIN CRUCIAL


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Though doctors are trying to improve breast-cancer screening, women still play a major role by regularly checking their breasts. "Self-discovery of a breast lump likely represents the best 'save' for women diagnosed with breast cancer," said Dr. Louis Potters, chairman of radiation medicine at the North Shore-LIJ Health System in Manhasset.

With or without breast self-exams, though, women without cancer symptoms should have a clinical breast exam every three years during their 20s and 30s and then annually, along with a mammogram, starting at age 40, according to American Cancer Society recommendations.

Despite other advances, the mammogram is crucial to detecting breast cancer and is "really a step that can't be bypassed," said Dr. Kenneth Goodman, chairman of radiology at St. Francis Hospital in Roslyn.

2. ULTRASOUND MAY BE USED TO GAUGE A SUSPICIOUS LUMP

A mammogram can indicate a lump in the breast, "but you may not be able to tell if it's solid and of concern or a fluid-filled mass -- cystic -- that doesn't have as much reason for concern," Goodman explained.

That's when an ultrasound examination becomes helpful. It can provide information that allows the doctor to decide on the next step -- a biopsy, no further action or an MRI scan. An MRI may be used if the ultrasound results are inconclusive, if the woman has very dense breasts or if there's a strong history of breast cancer in her family, Goodman said.

3. AN MRI SCAN IS A FAIRLY NEW ADDITION TO THE PROTOCOL

Goodman said that doctors have been requesting MRI scans for women with suspicious breast lumps for about five to 10 years. The scans help doctors avoid unnecessary biopsies because they can indicate whether a mass is harmless, he said, where previously "you'd go straight to biopsy" after an ultrasound that showed signs of potential cancer. Potters added that it's still not clear, however, whether MRI scans should play a role in routine screening.

4. ADVANCES MAY NOT LOWER THE DEATH RATE FOR BREAST CANCER

Questions remain about whether advances in breast cancer screening are actually leading to longer life spans for women with the disease.

"We know that advanced imaging is likely to discover more cancers," Potters said, "but the data strongly suggest we are over-diagnosing cancers, and that some of these cancers may not need to be treated. In time, we will learn whether such aggressive imaging approaches pay off where it counts -- in saving lives."

5. FURTHER IMPROVEMENT IS ON THE HORIZON

A new type of mammogram offers a three-dimensional look at the breast through a technology called digital tomosynthesis. "It will be a very important technology going forward, but it's still being tested," Goodman said. "Preliminary results show that it's easier to read and more sensitive than a mammogram, but the problem is that it has a higher radiation dose."

If researchers can reduce the radiation level, he said, it may become the standard for mammography.

 

Radiation oncologists, diagnostic radiologists, nuclear medicine, vascular & interventional radiologist

This is the final installment of a 26-week series in which Newsday presents Castle Connolly's list of top Long Island doctors.

RADIATION ONCOLOGISTS

Dr. Jay Bosworth

6 Ohio Dr.

Lake Success

516-365-6544

Dr. Ezriel Diamond

688 Old Country Rd.

Plainview

516-932-6007

Dr. Richard Gewanter

MSKCC Long Island

1000 N. Village Ave.

Rockville Centre

516-256-3600

Dr. Jonathan Haas

Winthrop University Hospital

Radiation, Oncology and Cyberknife

264 Old Country Rd.

Mineola

516-663-2501

Dr. Lorraine Marin

HealthCare Partners

1225 Franklin Ave.

Garden City

516-515-8820

Dr. Allen Meek

Stony Brook Univ. Med. Center

Dept. Rad. Onc. - L2

100 Nicolls Rd.

Stony Brook

631-444-2327

Dr. Edward Mullen

South Nassau Comm. Hospital

One Healthy Way

Oceanside

516-632-3330

Dr. Tae Park

Stony Brook Univ. Med. Center

Fl. Level 2 - Rm. 664

Stony Brook

631-444-2210

Dr. Jed Pollack

Long Island Radiation Therapy

6 Ohio Dr.

Lake Success

516-394-8100

Dr. Louis Potters

LIJ Medical Center

Dept. Radiation Oncology

270-05 76th Ave.

New Hyde Park

718-470-7190

DIAGNOSTIC RADIOLOGISTS

Dr. William Brancaccio

240 Meeting House Lane

Radiology Dept.

Southampton

631-726-8411

Dr. Kenneth Goodman

100 Port Washington Blvd.

Roslyn

516-562-6500

Dr. Jay Hammel

4277 Hempstead Tpke.

Bethpage

516-796-4340

Dr. Janet Hoffman

270-05 76th Ave.

New Hyde Park

718-470-7144

Dr. Arfa Khan

270-05 76th Ave.

New Hyde Park

718-470-3456

Dr. David Kirshy

1333 Roanoke Ave.

Riverhead

631-727-2755

Dr. Michael Laucella

375 E. Main St.

Bay Shore

631-665-2261

Dr. Seth Mankes

Stony Brook Univ. Med. Center

Radiology Dept.

HSC/Level 4/Rm. 120

Stony Brook

631-444-7224

Dr. Abraham Port

Complete Women's Imaging

440 Merrick Rd.

Oceanside

516-222-4873

Dr. Dennis Rossi

Elmont MRI

545 Elmont Rd.

Elmont

516-328-7200

Dr. Scott Sherman

100 Port Washington Blvd.

Roslyn

516-562-6511

Dr. Steven Weck

Glen Cove Hospital

Dept. Radiology

101 St. Andrew's Lane

Glen Cove

516-674-7540

Dr. Sydney Yoon

1 Healthy Way

Oceanside

516-632-4660

NUCLEAR MEDICINE

Dr. Christopher Palestro

Nuclear Medicine

270-05 76th Ave.

New Hyde Park

718-470-7080

Dr. Elizabeth Yung

259 First St.

Mineola

516-663-2778

VASCULAR & INTERVENTIONAL RADIOLOGIST

Dr. Kenneth Crystal

100 Port Washington Blvd.

Roslyn

516-562-6509

 

How they were picked

Castle Connolly Medical Ltd. is a health care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.

Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Not every good physician makes the list. Rather, the list is a way for patients to get started on their search for the best medical professional. Newsday is not part of the selection process.

Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.

 

To see the whole list . . .

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.

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