Breast cancer surgeon: Why people should choose MD Anderson first

When I was growing up, it always amazed me how my pediatrician could ask just five or six questions, and then magically know exactly what to do or which medicine to prescribe. That was one of the reasons I became a doctor.

In medical school, I focused on breast cancer because it interested me. I became a surgeon because I could better direct patients’ care. And I chose to work at MD Anderson because I admire its multidisciplinary approach.

What sets MD Anderson apart

As a physician myself, I want to go wherever people specialize in whatever is being treated. That’s why I tell people to come to MD Anderson first for cancer treatment. Because your first shot is your best shot at beating cancer. And when patients come to us after they’ve already received treatment elsewhere, their cancer treatment is often more challenging, due to mistakes made along the way at other places.

Patients are not just a number or a disease process here. MD Anderson’s patient-centered approach brings physicians from various subspecialties together to make a plan. This approach is what sets us apart. And it leads to better outcomes, so we have a lot of happy endings.

How cancer treatment has changed

Cancer is an ever-changing field, and it advances very quickly. Even since I completed my residency four years ago, we’ve found new ways to attack the disease, more diverse treatments (such as targeted therapy), and more cures.

One of the biggest changes in our approach to cancer is offering less surgery. Instead of removing all lymph nodes from a particular area, for instance, we might remove only the ones most likely to be cancerous, if the disease has spread. This reduces patients’ risk of developing lymphedema, in which fluid builds up in areas where lymph nodes have been removed, causing swelling in the surrounding tissues.

I know it might seem counterintuitive that a surgeon would be excited about the prospect of less surgery. But no surgical procedure comes without some risk, so being able to offer less surgery while still effectively treating cancer is a really meaningful change.

Putting myself in my patients’ shoes

Sometimes I picture cancer as individual cells and sometimes I think of it as a barrier made of blocks. But no matter how I see it in my head, the next thought is always, “How can I disassemble this?” And then, “How can I keep it from coming back?”

Still, everyone measures winning differently. Sometimes that means completing treatment and being cancer-free. And sometimes it means making it to see the birth of a grandchild, a child’s graduation or a wedding. For these patients, the focus is on quality of life, not just quantity.   

So, I always try to put myself in the patient’s shoes when making a recommendation for a treatment plan. I think that’s the only way you can really understand what each person is going through — and ultimately, help them decide what the best choice is for them.

Makesha Miggins, M.D., is a surgeon who specializes in breast cancer at MD Anderson in Sugar Land.

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