One in eight women will receive a breast cancer diagnosis in her lifetime, the National Breast Cancer Foundation, Inc., estimates.
That staggering number is why healthcare organizations, researchers, nonprofit advocates, and millions of Americans shine a spotlight on breast cancer each October.
In recognition of Breast Cancer Awareness Month, Spectrum is highlighting the essential roles our physicians play to make the collaborative care of breast cancer patients as effective and personalized as possible.
A critical piece of that team approach happens during multidisciplinary “tumor board” meetings and ongoing communication that follows. Spectrum’s pathologists, radiologists, and radiation oncologists are regular participants in these meetings at cancer treatment centers in Maine and New Hampshire.
The Power of Multidisciplinary Expertise
A tumor board is a meeting made up of specialized doctors and other health care providers (often including nurses, genetic specialists, and social workers) who assemble regularly to discuss patients with especially complicated, uncommon, or unusual cancer cases – as well as patients whose standard treatment is not working as it should.
Just as cancer patients often rely on a team of family, friends, and community resources to navigate their treatment, it also takes a team of health care professionals to ensure every patient is getting the type of care that is best for them. Tumor boards bring together specialists to collaborate – and personalize each treatment plan.
Bringing Clarity to Complex Breast Cancer Cases
Pathologists often work behind the scenes. But in breast cancer care, their role is front and center – especially during weekly tumor board meetings. Their training enables them to see and interpret subtleties under a microscope.
“Tumor board is a multidisciplinary meeting where the team reviews a patient’s clinical, radiographic, and pathology findings to develop and agree on the treatment plan,” says Kim Ginevan, MD, Spectrum pathologist and content lead on the Breast Pod at MaineHealth Maine Medical Center Portland. “Everyone is in the room at the same time, and that collaborative space really matters.”
Spectrum pathologist Jeannine Ritchie, MD, chief of pathology and laboratory medical director at Exeter Hospital, agrees.
“My role is to show pathology slides, walk through the report, and explain any unusual or complex findings,” she says. “Breast cancer care is incredibly nuanced, and the tumor board gives us the chance to consider every detail before moving forward.”
Drs. Ginevan and Ritchie guide the group through each case – highlighting critical elements of the pathology report and offering insight into diagnostic details that may influence next steps.
“The pathology report includes features such as tumor type, grade, size, margin status, and biomarker profile,” says Dr. Ginevan. “These reports can be long and complex. Some days reviewing complex breast cases and creating incredibly detailed reports feels like a labor of love – but I know they matter deeply in guiding care.”
Dr. Ritchie adds, “It also helps determine the need for additional molecular testing or systemic therapies like chemotherapy. And we’re there to help clinicians understand all aspects of the report – especially when the findings are more subtle.”
Dr. Ginevan makes it clear that the discussion is ongoing.
“That communication continues beyond the meeting whether it’s by phone, secure email messages, or texts – the lines are always open,” Dr. Ginevan explains. “We do whatever it takes to provide information and support the team, ensuring the best possible outcome for each patient.”
From Detection to Diagnosis
Thanks to screening exams and specialized training, radiologists are often the first physicians to detect a patient’s cancer.
“Even if a patient presents with a lump, a radiologist is usually the first to deliver the diagnosis,” says Elizabeth Pietras, MD, director of breast imaging at MaineHealth Maine Medical Center Portland and Spectrum’s division director of breast imaging. “We guide additional imaging like ultrasound or MRI, perform biopsies, and often call patients with the results.”
Radiologists also support staging, which is the process of identifying what “stage” a cancer has progressed to, by measuring tumor size, evaluating lymph nodes, and identifying potential spread.
“Radiologists play a crucial role in multidisciplinary tumor boards by assisting in the interpretation of complex imaging findings,” Dr. Pietras says. “Additional suspicious findings may reveal other sites of disease that can alter staging, prognosis, or treatment.”
Dr. Pietras adds, “Tumor board discussions often uncover important details that might be missed without thorough collaboration across specialties. It keeps clinicians up-to-date and helps patients get the best information about their treatment options – which hopefully leads to the best outcomes.”
No ‘One-Size-Fits-All’ Solution
“As a radiation oncologist at tumor board, my role is to critically evaluate each case and determine whether our therapy may benefit the patient – thoughtfully applying experience and available data,” says Matthew Cheney, MD, PhD, managing director of Spectrum’s radiation oncology division.
“While guidelines exist, each case is unique and must be considered from the perspective of all involved disciplines,” adds Dr. Cheney. “There’s no one-size-fits-all solution, so we aim to make our recommendations as targeted and precise as our treatments – every time, all the time.”
Tumor board, he says, is invaluable for its real-time collaboration across specialties – resolving questions efficiently and thoroughly. “This isn’t possible if each specialist works in isolation,” Dr. Cheney explains. “It allows for a broader consideration of treatment options than would occur in a vacuum.”
It also helps bring subspecialty expertise to patients – no matter where they live. “In a state as geographically large as Maine, tumor board lets patients have their case reviewed by high-volume specialists with unique training who may not be available locally,” he adds. “The value of teamwork and collaboration cannot be understated – and tumor boards provide a venue to build these relationships.”
Considering Complex Medical & Life Challenges
It is challenging cases that often benefit most from the tumor board’s group insights at the table. “Sometimes it’s about treatment decisions, such as choosing between a lumpectomy versus a mastectomy,” says Dr. Ginevan. “Other times, there are comorbidities or social factors that influence what’s safe or feasible for the patient.”
Dr. Ritchie points to a case where the treatment plan shifted during tumor board discussion.
“A patient was scheduled for 25 radiation sessions over five weeks,” says Dr. Ritchie. “But when the social worker shared serious transportation challenges, we adjusted the plan – same total dose, only now delivered over five visits in one week. Without that conversation, the patient might not have completed treatment.”
A Shared Passion for Exceptional Care
“I’m fortunate to work with physicians who are truly invested in high-quality care,” says Dr. Ginevan. “When doctors are passionate about what they do, you feel it – and patients feel it too.”
That kind of commitment shows up every time the breast tumor board meets.
“There are so many possible combinations of surgery, chemotherapy, hormone therapy, and radiation,” Dr. Ritchie says. “A multidisciplinary approach helps us distill that complexity into a plan that’s both clear and tailored to the patient. I enjoy turning complicated diagnoses into clear reports that guide care – and I love knowing we’re part of a team that ensures each patient gets the very best of what we have to offer.”
