NEW YORKThe American Society of Breast Disease (ASBD) began in
1976 as a relatively small group of physicians interested in studying
diseases of the breast. It soon expanded into a multi-disciplinary
organization whose stated mission is to provide a forum for
learning and sharing new developments related to breast disease.
The operative word for this group is multidisciplinary.
Today, the Society draws its membership from a broad spectrum of
disciplines, including oncology subspecialties as well as the primary
care community and allied health professionals involved in patient
care and research.
This makes sense, according to ASBD president Andrew D. Seidman, MD,
because breast disease runs the gamut from conditions that will never
be cancerous to treatable forms of early breast cancer to advanced
incurable cancer, and draws upon the expertise of people from many
different professional backgrounds.
Dr. Seidman, associate attending at Memorial Sloan-Ketterings
Breast Cancer Medicine Service, believes that any health care
professional interested in increasing his or her knowledge about the
management of breast disease should consider membership in the ASBD.
In an interview with ONI, he explains why.
ONI: What distinguishes the American Society of
Breast Disease from other professional oncology organizations?
Dr. Seidman: The structure and philosophy of ASBD represent a
unique conceptual prototype. The inclusion of physicians from the
world of medical oncology, surgical oncology, radiation oncology,
pathology, and radiology, to name a few, has created a forum that is
quite unusual in the medical community. Its really uncommon for
physicians from so many different subspecialties to gather to share
their own perspectives on a specific disease. Very few other
organizations strive to be so inclusive in terms of the various
modalities in treating a particular disease.
ONI: When did you become aware of ASBD, and what drew you
to the organization?
Dr. Seidman: I became aware of the ASBD in 1990 during my
fellowship at Memorial Sloan-Kettering Cancer Center. At that time,
the president was Dr. Gabriel Hortobagyi, chief of the Breast Service
at M.D. Anderson Cancer Center. I began to attend meetings and became
active as a board member about 5 years ago.
It struck me when I first became involved with this organization that
there was a great amount of untapped potential. The organization had
only grown to approximately 500 members, which I found somewhat odd
given the cross-disciplinary focus and the tremendous potential for
drawing in people from various disciplines who share this common
interest in breast disease.
ONI: Have you established any membership goals?
Dr. Seidman: ASBD has over 700 members right now. We would
like to see our membership essentially triple to more than 2,000
members by the year 2005. I think this goal is very realistic, given
the diversity of health care professionals and also the inclusion of
advocates and consumers in our organization, and reaching it will
make ASBD even more vibrant and foster new initiatives.
I especially anticipate membership expansion among primary care
physicians. Again, this largely relates to the appropriate emphasis
on early detection and prevention, and management of premalignant
lesions of the breast. Im really talking about internal
medicine, family practice, and gynecology.
I truly believe that primary care physicians, my colleagues on the
front lines, are under-represented in the strategic effort to defeat
breast cancer. These groups play an important part in ASBD, and I
hope they will become increasingly active in coming years.
ONI: What are some of the benefits of ASBD membership?
Dr. Seidman: We publish an official journal, The Breast
Journal, and also offer a second journal for our members, Breast
Diseases: A Year Book Quarterly.
Through our website, we try to keep our membership advised about new
and noteworthy reports regarding the management of breast disease,
and in the future we would like to see this expand to provide a real
interactive forum for the exchange of ideas and also for addressing
difficult questions that might not be easily answered through
conventional means, such as letters to the editor.
ONI: How does ASBDs multidis-ciplinary model
translate into better care?
Dr. Seidman: The representation of many different
subspecialties with various specific interests such as genetics,
nutrition, surgery, pathology, and imaging, all force us to know a
little bit more about what our colleagues are doing. Therefore, we
serve our patients well in the end by broadening our own knowledge
base about the management of breast disease.
By bringing different perspectives together, physicians may make
connections that might not otherwise be established. I think this
concept of cross-fertilization is very real, and some of
the informal discussions that take place among the various
specialists at our meetings are the seeds for future research.
ONI: Would ASBD have an active role in initiating
Dr. Seidman: Thus far, the Society has not actively supported
research, but this is something that we hope to do in the future. For
example, we plan to provide support for research fellows and special
fellowships that are geared toward fostering true interdisciplinary
breast cancer research. This approach would differ from existing
research awards by mandating interdisciplinary collaboration.
ONI: As a multidisciplinary organization with an
interest in varied perspectives, what is ASBDs position on
complementary or so-called alternative medicine?
Dr. Seidman: Anyone involved in the care of women with breast
disease or breast cancer is acutely aware of the need to integrate
nonconventional approaches into patient management. We often get
specific queries from physicians to our board regarding alternative
or complementary medicines.
We have addressed nontraditional approaches in some of our past
meetings, and Dr. Barrie Cassileth, who is chief of the Integrative
Medicine Service at Memorial Sloan-Kettering, will be discussing some
of these issues at our annual meeting next year.
ONI: When will this meeting take place?
Dr. Seidman: Our 25th annual meeting will be held April 27
through 29, 2001, in New York City. The program will address a full
spectrum of issues ranging from premalignant breast disease to early
breast cancer to advanced breast cancer. We will also be looking
toward the future, examining new agents and drugs that are in
development for treating breast cancer.
Dr. Larry Norton, our keynote speaker, will provide a personal and
historical perspective on the evolution of postoperative adjuvant
therapy for breast cancer over the last 3 decades. Other speakers
will include Drs. William Gradishar, Gabriel Hortobagyi, Clifford
Hudis, and Eric Rowinsky, to name a few.
Additionally, Dr. Edward Stadtmauer, principal investigator for the
largest randomized prospective trial of high-dose chemotherapy (HDCT)
for breast cancer, will provide his perspective on the current status
of HDCT for breast cancer. Were also fortunate to have Dr.
Robert Buckman speak to us on how to break bad news to patients.
ONI: Is ASBD involved in any lobbying or legislative initiatives?
Dr. Seidman: This has not been a focus for our Society
historically. Other groups are doing this and doing it quite
effectively. I think, though, that we may be able to provide a unique
voice on issues, given the nature of our membership, which
distinguishes us from, for example, the National Alliance of Breast
Cancer Organizations, or the National Breast Cancer Coalition, or the
We have a collection of talented, dedicated professionals who have
significant knowledge of issues and often of policy as it relates to
managing breast cancer. I would like to see us have a voice in
legislative and policy issues that could help improve health care for
patients with breast disease.
ONI: What objectives did you personally establish
for yourself as president of ASBD?
Dr. Seidman: Personally, I thought that the organization was
on a very good trajectory in terms of its mission. However, as a
medical oncologist, I thought that the Society had much to offer my
colleagues in medical oncology and that not many of them were either
aware of the Society or knew enough about it to decide whether the
group offered something worthwhile for them.
I think that we have recently achieved some measure of success in
expanding the representation of medical oncologists within the
For ASBD to grow, we need to achieve a certain critical mass, not
only in terms of membership but also in terms of home office
strength, within our Dallas office. Further, we need to have the
resources to pursue new initiatives. To this extent, I am proud and
grateful that many people in the pharmaceutical and biotech industry
have recognized the value of the ASBD and have been generous in
supporting some of our endeavors.
ONI: What is your vision for the future of ASBD?
Dr. Seidman: I think our greatest strength is that, due to the
nature of our membership and our focus, we force ourselves to become
more expert in areas and disciplines that we have not been formally
trained in, and I think this makes us better health care providers
and stimulates new avenues of research.
I believe this will continue, and my hope is that more health care
professionals will learn about us and bring their unique talents and
their knowledge to us so that we can grow and draw upon the
dedication and talents of many of the people who currently arent
aware of the American Society of Breast Disease.
The American Society of Breast Disease (ASBD) can be reached at PO
Box 140186, Dallas, TX 75214; phone: (214)-368-6836; website: www.asbd.org.