Tailored Cancer Care: Less Can Be More

Less is more. That’s the philosophy earning fans (and foes) for Dr. Laura Esserman, director of the University of California San Francisco’s Carol Franc Buck Breast Care Center. The doctor has long preferred a less invasive approach when treating the breast condition known as DCIS (ductal carcinoma in situ). Conventional treatment often means biopsy, surgery and radiation. Dr. Esserman favors a lighter touch—see the patient regularly, but hold off on surgery (and its side effects) in cases that aren’t likely to become life-threatening. Recent research indicates outcomes are similar. The doctor—known to sing patients requested songs as they go under anesthesia—is not new to crooning an unconventional tune:she was an early supporter of scaling back cancer screening to reduce overdiagnosis and unnecessary procedures. Again, new research backs her up. Now, she and others are conducting another study to find the best approach for tailored screening. “New and novel” is becoming a familiar refrain for Esserman.