“As a physician, I know how important it is to get the right diagnosis from the start. Your diagnosis determines the road map for your entire course of care.”
So when a recent mammogram showed a lump in her left breast, Cline wondered, “how will I make time to deal with this?”
The answer: MD Anderson in the Bay Area, just a stone’s throw from Cline’s busy pediatric practice in Dickinson, Texas. There, patients can access the same level of world-class cancer care available at MD Anderson’s Texas Medical Center campus — but without the commute.
“I was very reassured to know I had a cancer-fighting dream team in my own neighborhood,” Cline says.
She fought hard, and after chemo, radiation and surgery, she’s cancer-free.
“It was a whirlwind,” she says, “but combating cancer on my own turf was a godsend.”
Peace of mind
Cline’s cancer journey began when a routine mammogram performed at an imaging center in Dickinson revealed the lump. A biopsy was taken and sent to MD Anderson for analysis. Cline says knowing MD Anderson pathologists were reading her slides gave her great peace of mind.
MD Anderson confirmed the tissue was indeed cancerous, and enrolled Cline as a patient at its Bay Area location, which was established in 2007 on the campus of CHRISTUS St. John Hospital in nearby Nassau Bay.
Power in numbers
But not all pathology reports are as accurate as Cline's. Lavinia Middleton, M.D., a professor of Pathology at MD Anderson, led a recent study that revealed the second opinions provided by MD Anderson pathologists found errors in pathology read by others up to 25% of the time.
A separate study showed that MD Anderson pathologists pinpointed errors 10% of the time in breast biopsies alone.
Sometimes, erroneous readings reported that surgery had removed all of a patient’s cancer, yet MD Anderson pathologists detected cancer cells that had been left behind. Other times, cancers were misdiagnosed as the wrong type of cancer. But the happiest discoveries came when MD Anderson pathologists could correct a tumor’s diagnosis from malignant to benign.
MD Anderson pathologists aren’t smarter or better than their counterparts, Middleton says, but MD Anderson pathologists do have an advantage.“
Because MD Anderson has such a large patient volume, our pathologists have the luxury of sub-specializing,” she explains. “One group looks at breast cancer slides only, all day, every day. Another group analyzes brain and spinal tissue slides, exclusively. Yet another group interprets skin cancer slides. When you do the same thing day in and day out, you get really good at it. You understand all the nuances of what you’re seeing, and you catch subtleties others may miss.”
And because MD Anderson is a large organization, its pathology staff is large, too. Sixty faculty members staff the Pathology Department.
“We consult and bounce things off each other,” Middleton says. “We ask our colleagues to weigh in.”
A lone pathologist working in the community has a very difficult job, she adds.
“When you work alone, you have to recognize everything. One minute you’re analyzing breast tissue, the next minute you’re analyzing a colon polyp,” Middleton explains. “We have a lot of respect for the community-based pathologist who has to know it all.”
Eliminating ‘double work’
Because of MD Anderson’s reputation, the cancer center’s pathology department is often asked to provide second opinions for slides read by others. In pathology, this practice is called “over-reading.”
To eliminate this “double-work,” MD Anderson is partnering with imaging centers like the one Cline visited in Dickinson. Instead of asking the institution to provide second opinions for patients’ pathology reports, the partnering centers send samples straight to MD Anderson.
“Removing redundancy means patients can enroll in MD Anderson more quickly, and begin treatment faster,” says Richard Ehlers, M.D., medical director of MD Anderson in the Bay Area.“When you have cancer, that’s important.”