Dr. Antony Pais
Being in the field of Surgical Oncology from the past 22 years, I realized that trying to be a specialist in more than one organ or site is actually doing no justice to yourself and the patient. Today we have the facilities, training, experience and knowledge equal to the best centers in the world but why are we still behind?
The reason is that we are not focused. If we only concentrate on one organ or site with our population and numbers, we can be the best in no time. I was trying to do this in every institution I had worked earlier but failed to achieve my dream.
It was only because of a similar vision by Dr. Devi Shetty and Ms. Kiran Mazumdar Shaw and the Captains of our team, is it possible to venture out and revolutionize the field of Oncology in our country.
Not all centers that call themselves a “Breast Center” qualify for this title. This cancer is the commonest cancer among women in India and the most feared disease. It is sad to know that a disease that is common, curable, easily detectable, and treated is the one most often mismanaged.
We have lacunae with no standardization at every step, from screening, diagnosis to treatment and follow-up. It is not true to say that breast cancer is a systemic disease from the start and chemotherapy or radiation therapy covers our faults.
An excellent surgical resection is still the answer from the time of Prof. Halstead till today with only a small benefit from Chemotherapy and Radiation therapy. It is said that 50% of patients treated by surgeons not trained in breast cancer have had incomplete surgery [Tata Memorial data].
In my experience, I have seen that our patient spends nearly 30-50% more on unnecessary investigations and improper treatment when treated in a center not dedicated to breast cancer.
If we only correct this and with the money saved we could treat another 30% of our patients free of cost. It is this that drives me to make it a center of excellence. We have set up standards for screening, accurate diagnosis, quality of surgical resections, reconstructions and palliative care. Our chemotherapy regimes and Radiation therapy is based on standard international guidelines considering the financial status of the patient and not going by market forces.
In summary our aim is to disassociate the financial status of the patient from the quality of Breast care received.