The Breast Evaluation Center/San Francisco opens as a primary care facility for the breast – the first of its kind with a comprehensive array of services never before offered in one facility.

The office door closes as she turns left to a row of black, pay telephones hanging on the lobby wall. I know this pattern. In just a few minutes there will be that phone call from her physician. I wait before seeing another patient.

“Hi Philip, is what I feel in her breast a cancer?”

The woman whose mammography I have just reviewed is in the lobby on hold. She is waiting to know: “Will I be in the hospital by this afternoon; in surgery this evening? Tomorrow morning, will I still have two breasts? What is my future?” Very likely these are her thoughts while waiting for a voice to return. Her future is on hold.

When I reflect on the frequency of this pattern, I become curious. Why? Mammography patients are the most frequent patients requesting results immediately even though the question is also one of cancer for many other patients.

Radiologists communicate only with the patient’s physician at this time. If I could gain additional important information about a breast abnormality with an ultrasound examination, a written request from her physician is required. It is not standard of care for a radiologist to report results directly to a patient or to do any additional imaging without a physician’s written order.

Searching the medical literature going back decades, I am both surprised and rewarded. I know that breast cancer is a major concern for women but cancer is not the most common breast abnormality! Many benign breast conditions, often mimicking cancer, are much more common. Not only are they not malignant, they do not need surgery and should be managed medically.

No one in the community is currently managing benign breast conditions medically. Every patient with a breast mass or problem is immediately referred to a surgeon. Strong evidence for excellent symptomatic relief for and management of benign abnormalities is in the literature. The most significant is the evidence that surgery can and should be avoided.


Professor Umberto Veronesi, a Milanese surgeon, publishes an excellent, prospective study which creates the first paradigm shift in breast surgery for decades. This seminal study, from the Tumor Institute of Milan, has data that limited breast tissue removal (partial mastectomy) could provide the same patient survival as complete breast removal (mastectomy – which is the standard since 1895). Mammography is critical for patient selection. Imaging identifies women eligible for “breast conservation surgery” - as it is now called.


Equipment developments improve breast imaging; identifying smaller cancers and more easily defining benign lesions. CGR, a French company, receives FDA approval for the first modern, low-dose radiation mammography machine.




The BEC/SF opens:

The center very shortly acquires new equipment: X-ray stereotactic needle biopsy table (recently FDA approved) allowing Fine Needle Aspiration (FNA) under x-ray guidance for abnormalities which cannot be felt.

BEC/SF is an early adopter of prevention programs offering exercise classes, stress reduction information and cooking classes with practical, tasty low-fat recipes.

Physicians visit to see and understand this new concept. Some go home and implement a few of our practices: some even borrow our unique and purposefully-created name!

Patients from Alaska, Panama, Florida, and New York City find their way to the Breast Evaluation Center/San Francisco.


Please contact us to learn more about any of our services.