Welcome to the The Visionary Breast Center
Welcome to our web-site! Who are we? Why the name change from Desert Breast Institute after nearly thirty years? How does the foundation factor into this now? Why are we visionary?
These are all legitimate questions. Before we get to the good stuff, let me briefly recount some of our history.
For the 12,000 plus women who have followed my career and participated in it as patients, they know that I’m always pushing the envelope for them. My primary concern is their welfare and keeping them out of harm’s way, being as good as I can get myself and being a voice for those who don’t have one. Our directive was to preserve mind, body and spirit. When I founded the Desert Breast Institute back in 1988, it was a vision that brought the first comprehensive breast center to the Coachella Valley and one of the first in the nation. My primary reason for promulgating Desert Breast Institute was to involve the many doctors diagnosing and treating breast cancer into one arena (so they corroborated before treatment was instituted based on needle biopsy) for the patients benefit. This made it so before I ever operated on a patient, the radiologist, oncologist and radiation therapist and GP’s could all have their input.
I was trained at a time (1970s) when we as surgeons were taught to ‘get it all.’ Essentially that meant the bigger the tumor, the bigger the knife we got out. That meant aggressive surgery. The human genome had yet to be discovered; surgeons had no real back up like we have today. Surgeons acted on their own personal bias. I wanted to change all that at the Desert Breast Institute. In addition to a comprehensive setting, I wanted to bring in National Cancer Institute clinical trials so we could provide patients with cutting-edge research. We were the first in the valley to do that as well.
Over the years in the valley we pioneered stereotactic core biopsy to avoid surgery. We developed new surgical techniques to better use APBR (Accelerated Partial Breast Radiation). We have even successfully treated patients with invasive breast cancer without surgery, and they are all alive 18 years later. More recently we have researched Modified Military Infrared, participated in Pharmacogenomic clinical trials, Vaccine trials and cryogenic surgery all in an effort to achieve not only better and better results but pioneering dramatically less invasive techniques. I wanted it to be so that surgically the patient couldn’t even tell we were there.
Over the years we accomplished those goals and in doing so raised the bar in the valley in regard to breast cancer diagnosis and treatment. The team I work with has been together for over thirty years. Collectively that’s over 120 years of experience. It takes a long time to know what they know. We’ve seen thousands of patients, honing our skills over that time period. I think our team is the best of the best—otherwise I wouldn’t trust them with the lives of our patients and I wouldn’t open the door. Along the way we have developed our own research protocols and methods, the results of which we publish on an ongoing basis. We have been invited to present our findings around the world. We are the only breast center in the valley, to my knowledge, that has done this consistently and who has maintained the same team for many years. It makes a difference.
In the beginning when mastectomies were rampant and we had rudimentary chemotherapy and radiation (compared to today’s model), we lost patients through late diagnosis. But that scenario is becoming less and less frequent as time goes by to the point that now very few of our patients die from breast cancer. I made a promise to three women who died back then (one in my arms in the hospital) that I would never give up the fight until we reached the goal to put this disease in the history books.
Our Tamoxifen breast cancer prevention trial accomplished part of that goal since it lowers the risk by 50% in high-risk women. It is active prevention. That clinical trial, FDA IND #34,223, authored by Dr. Bretz, was a real breakthrough in not only achieving the result of actually preventing breast cancer but in getting Big Pharma and the cancer community to look at prevention. Now there are three drugs that are FDA approved to prevent breast cancer. We made a big difference in coming up with that trial to make things better for women around the world. It all started in the Coachella Valley with cancer doctors that wanted to take on the system and make things better. No other cancer doctors anywhere had that idea back then and I am proud of my team that changed things scientifically worldwide as well as our working with the erstwhile Soviet Union back then to make the world safer. That clinical trial remains the highlight of our endeavors to not just be cutting edge but make the edge. There is a big difference.
Now we come to the last six years of pioneering research that melded together what I believe is an answer to breast cancer until if and when a magic bullet is found. I think we have put the pieces of the puzzle together. Technology I think has caught up to breast cancer if one cares to look. Of course that is part of the problem, since the modalities I have studied are not mainstream methods of diagnosing and treating breast cancer, but they work very well together if given the chance and you know how to use them. Genetics is changing everything in medicine. Those doctors that aren’t embracing that change are letting their patients down. There is a new medical journal called ‘Genome’. The editor is Jeanette McCarthy, MPH, PhD. In the first issue she says, and I quote, “While we celebrated the use of genomics in targeting cancer treatments, solving diagnostic dilemmas, and improving prenatal diagnosis, our enthusiasm was tempered by the low uptake on these technologies outside of academic medical centers. Further examination uncovered a healthcare system that was not primed to incorporate these advances, neither from a technical/logistical standpoint nor from an intellectual one. It was becoming increasingly clear that this field was going nowhere without knowledgeable healthcare providers, patients, and other stakeholders.”
I don’t think anyone with rudimentary knowledge of genetics doesn’t think this area of scientific endeavor isn’t life altering. Then why does she say it’s going nowhere?
She says it because doctors are finding it difficult to stay in practice, let alone learn a whole new area of science. We on the other hand saw the tidal wave of possibilities coming years ago (2002) and became one of the first principal investigators for the FDA clearance trial of a breast cancer genetic risk trial called OncoVue, developed by InterGenetics in Oklahoma. It was a saliva test that not only predicted a woman’s individual risk for breast cancer but when that risk would likely manifest within ten years during her life time. This was it, the crystal ball was here.
We could now predict if and when a woman would likely get breast cancer and then bring active prevention to bear, as well as deploy all the ancillary modalities (which have no radiation) in a time sensitive manner to PERSONALIZE CARE and diagnose ultra-small breast cancers (about 4mm). We were no longer shooting in the dark as it were. Breast cancer no longer had the upper hand of surprise; we could marshal our army of diagnostic and therapeutic modalities to preserve mind, body and spirit. It has worked very very well. The only problem was if you recall Doctor McCarthy’s comments (in 2014) in Genome, you can imagine that ten years ago no one was interested and the company has since failed. We are trying to resurrect it. We and they were ahead of our time as usual.
While not as precise, there are other genetic tests; BRAC 1&2 are the older ones. We can still use genetics risk tests to give direction. Personalized care means we use the genetics to determine when and how often we use the other diagnostic modalities instead of the usual woman randomly coming in to a breast center once a year and then forgetting about it until next year. That one event, a yearly mammogram, which mostly the patient never gets to see, let alone discuss—getting that done and forgetting about it is the reason we still have the same number of 40,000 dying each year while over 200,000 get breast cancer in the U.S. The system faces many obstacles to optimal breast care. One is that even after forty plus years of advancing mammographic technology, there is still a 20% false negative rate. Worse, even if a woman is high risk we just can’t do mammograms/MRI/CAT scans and the like every six months because we will give the patient cancer from excessive radiation—besides it being cost prohibitive. Now there are new guidelines, in essence, withholding mammography until after 50 years of age. That won’t help especially in high risk women who don’t even know they’re high risk. Unknown to too many is that 90% of breast cancers occur in women with no family history. Interestingly there was no real backlash from the medical community to change those new guidelines. When the edict comes down, many doctors just accept it, even if it means bad patient care. It seems doctors can be manipulated to do whatever is wanted of them. The system is not working optimally.
THE GOOD STUFF
By involving the patient early on in educational opportunities and genetic testing, The Visionary Breast Center makes a difference and provides the foundation needed to make that very early diagnosis so that perhaps we can avoid traditional surgery, chemotherapy and radiation. How wonderful would it be—remembering grandma’s generation of mastectomies, arm swelling, chemotherapy/radiation sickness etc.—to actually prevent it in the first place.
Or if you did get it to receive treatment for your breast cancer in a comfortable office setting outside the hospital in a 20-minute procedure that permits resuming normal activity immediately without even a stitch? That’s the quantum leap I have been after all these years until a vaccine or other magic bullet is discovered.
In fact, we have now performed several cryoablation procedures and we have come to call it, ‘The Lavender Procedure’, so-called because there is a restaurant across the street from The Visionary Breast Center and usually the patients feel so good after their procedure they are able to go across and have dinner. Within 20 minutes of her procedure, one of our first patients was eating lobster salad and drinking chardonnay, no stitches no incision. It was a milestone in my career and for women.
Subsequent imaging studies show total resolution of the cancer and biopsies thus far show 100% cancer kill in the breast. We had achieved what I had set out to do years ago. These are selected patients using genetic studies to determine recurrence risk etc., and utilizing anti-estrogen therapy after, but by and large I believe we can do this nearly every time if we have a woman who comes in early on and we individualize her surveillance program. We can make these very early diagnoses that permit the Lavender Procedure in selected patients.
The other diagnostic modalities we have researched are Modified Military Infrared, SureTouch, Halo, Elastography/Ultrasound and increasingly other genetic studies. Of course this is another first for us. That’s not why we did it. When you’re looking for the best least invasive manner to diagnose and treat breast cancer, one has to be relentless in that pursuit.
In another first, The Visionary Breast Center is inaugurating the mentor program. That is, each patient will be assigned a mentor who will be available to her for any questions referencing studies, diagnostic or therapeutic procedures. You will have her personal cell number to access help and to get to Dr. Bretz or others. We are also developing a reference library for our patients to read the latest literature of interest.
We changed the name to The Visionary Breast Center because our previous goals were met and we are morphing into something different and advanced far beyond what even I could have imagined back in 1988. Through the generous support of the Wood Group, I have been able to set forth a new agenda. At a time when most doctors my age are retiring or worse, I feel as though I have a new path to follow and another mountain to scale. Our goal is to multiply our concept so women all over the country can take advantage of these opportunities. It just takes so long (if ever) for the system to kick in—especially when it’s technology the medical establishment doesn’t understand and doesn’t want to take the time to understand.
As many of you know, I started a non-profit foundation, The Desert Breast Foundation which up until now has been on the back burner. With the support of the Wood Group, all the services we offer at The Visionary Breast Center will now be free of charge on a once a year basis (except for surgeries and genetic testing).
Should you be compelled to offer a donation to the foundation because you feel our endeavors should be preserved and to help us provide even more care and expand centers, then so be it. However, your care will not depend on any donation whatsoever. Therefore, from now on we will not be accepting insurance.
Every patient will be offered an opportunity to receive our handbook. It will serve as your personal journey with all the important data at your fingertips. In it is valuable information including imaging reports, a dictionary, a detailed discussion of surgical, chemotherapy and radiations options, etc. These various topics will be elucidated by respective members of the team. They will not just provide a cut and dry definition of a procedure or word but how they actually have used it over the years and what it means to them and you.
Lastly to recap the premise of The Visionary Breast Center is to early on (in a twenty something but it’s never too late) lay out a personalized surveillance program for life based on genetics. This will help ensure as best we can the finding of ultra-small breast cancers that will enable us to use our cryogenic procedure and perhaps avoid traditional surgery, chemotherapy and radiation. Our intent is to also bring this concept to women of the world.
This is important because by 2030 70% of all breast cancers will occur outside traditional countries like the U.S, Canada and Eastern European countries and they will arise in countries like China, India, Brazil and the Pacific Rim.
If you have any questions please ask them and let us know of anything you feel we can improve upon. After all, our purpose is to serve you the best way we can. For additional services you will have an opportunity to become members of The Visionary Breast Center at different levels where you feel you would like to be and thus take advantage of those options. Many women may choose to just come in that once a year but for those who want and need more, we are here.
Phillip Bretz, M.D.