Unique Physician Partnership Demonstrates Benefits of Collaboration

It’s long been said that two heads are better than one, and a pair of doctors who practice at Tucson Medical Center find it’s certainly true when it comes to breast cancer surgeries.

Typically, a general surgeon might complete a surgery, and then turn the patient over to the plastic surgeon, who often arrives nearing the completion of the cancer surgery. At that point, the doctor inherits whatever choices were made by the previous surgeon – as well as any complications.

But general surgeon Vanessa Roeder and reconstructive surgeon Edward Eades do things differently. Dr. Eades will show up before the patient is even put under anesthesia so the two are on the same page about the approach. He then stays with Dr. Roeder as she completes her work. Dr. Roeder, in turn, stays with her colleague as he finishes his.

“It’s not done in very many places because it’s not considered a good use of each other’s time,” Dr. Eades explained. “We end up spending a lot more time in surgery than we otherwise would, but it gives superior results. There’s no question it’s better for the patient.”

 The collaboration means Dr. Eades is not surprised when he takes over the reconstructive part of the surgery, ensuring the best cosmetic result.

“First and foremost, you have to treat the cancer and it has to be medically safe,” Dr. Roeder said. “But there are a number of ways you can do a good, safe operation. If you think about the aesthetics up front and it doesn’t change the safety of the operation, so much the better.”

Take a lumpectomy, for example. In many cases, radiation will be the preferred treatment following surgery.

It’s far easier to do reconstruction work on tissue that hasn’t been irradiated, given subsequent decreased blood flow and a possible tightening of the skin, the doctors noted. 

If the patient would benefit from a breast reduction, the two can work together to simultaneously remove the cancerous tissue while doing the cosmetic work, rather than trying to do the work post-radiation. “For many patients, they end up with prettier breasts than when we started,” Dr. Eades said.

That’s not important to all women, he noted. But there are many who do place importance on aesthetics. “For some women, if a patient feels better about herself, it can really make a difference in her recovery,” Dr. Eades said.

Assisting the two in their work is a machine that has recently been added to the operating room at Tucson Medical Center, called the SPY Elite system.

The machine resolves a longstanding challenge for physicians in that it’s often difficult to gauge the viability of skin that can be used to reconstruct the breast mound. If the tissue has poor blood supply, it could decay and trigger infection and other complications, requiring another round of surgery.

Using a dye injected into the bloodstream, the new technology illuminates tissue with a strong blood supply, helping surgeons ensure they’re working with tissue that has the strongest chance of surviving.

Just as importantly, it also allows surgeons to double-check after completion of the surgery.

In the classic reconstruction, a tissue expander is placed under the muscle. Slowly, over the course of several months, it is filled with increasing amounts of fluid to help stretch the skin to make way for an implant. In some patients, however, given enough skin and sufficient blood supply, the implant can be put in right away, instead of having to go through the expansion and second surgery. That’s when the machine can really come in handy.

“If the skin has to stretch too much and doesn’t have a good blood supply, then the skin can die and break down and you lose everything and have to start again,” Dr. Eades said. “With this machine, we can check before we put the implant in, and then after as well, to make sure we have the best chance of success. We’re using it in every case we do now.”

Dr. Roeder said the strong working relationship between the surgeons helps provide patients with a wealth of information and choices. She lays out some of the initial options, then Dr. Eades goes through them again with his own input. “Between the two of us, we often help people go down the right pathway,” she said.

The two surgeons have been double-teaming on surgeries for more than a year now, ever since they went to a conference in February 2011 and heard from Pat Maxwell, a world-renowned plastic surgeon about best practices and collaboration. “We looked at each other said, ‘That’s how we should do it,’” Dr. Eades recalled.

Dr. Eades recently returned from a small conference in California that brought together 20 physicians from around the country who do a significant amount of breast reconstruction work. “I was in a room with 19 other guys who do this kind of work, and they were all so envious of me because I get to work with my general surgeon at the start of surgery.”

Dr. Roeder, who said one of the upsides of the partnership is the chance to gain new knowledge, said she’s starting to hear about more partnerships forming, but it’s slow. “It’s a trend, and it’s a good trend,” she said. “If you work together, you can do an even better job for the patients. To have a plastic surgeon willing to take the extra time when they really don’t get the financial reward is amazing. It takes a special person and Dr. Eades is one of those.”

Trackbacks

  1. […] Eades and Roeder is an unusual one, but one that has huge benefits for the patient. Read more in this post from TMCAZNews. Share this:TwitterFacebookEmailLike this:LikeBe the first to like this […]

  2. […] Vanessa Roeder, regarding the number of women undergoing this type of surgery here in Tucson. The physicians work together to help women with a breast cancer diagnosis or who have tested positive for a BRCA mutation as […]

Leave a Reply


Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461
%d bloggers like this: