History of Breastlink

Commitment to optimal breast health

Breast Cancer Resources | BreastlinkWhile many of our doctors are regarded as leading practitioners in their field, we are humble enough to know the current state of medical knowledge about breast cancer changes on a continual basis. Breastlink doctors are encouraged to engage in intellectual dialogue with researchers and doctors, many of whom are not necessarily affiliated with Breastlink. This is why our doctors not only attend medical conferences across the country, but we invite leading researchers to speak at our centers.

Our doctors have treated thousands of patients with breast cancer. Our doctors understand that evidence-based breast cancer research is leading the way to better treatment decisions today and into the future. We also understand the need to listen – and engage – with our patients in the decision-making process.

History of Breast Cancer Treatment

Treatment for patients with breast cancer has come a long way since the first written descriptions of breast tumors more than 1,800 years ago. Humanity waited until the 17th century, when we began to understand the role of our circulatory system, to find a connection between breast cancer and the lymph nodes.

This essential finding led to procedures to remove lymph nodes, breast tissue and underlying chest muscles (a radical mastectomy) — the first evidence-based treatment option to treat breast tumors. William Halsted, M.D. performed the first radical mastectomy in 1882.

Patients with suspicious masses in their breasts were placed under anesthesia. If the tumor biopsy confirmed a breast cancer diagnosis, an immediate radical mastectomy was completed. Many women woke up only to be informed they had lost their entire breast – there was not a conversation between a doctor and the patient about treatment options. This remained the standard treatment until the mid-1970’s.

The invention of the modern mammogram in 1969 enabled doctors and patients to find smaller breast cancers. While x-rays had been in use for decades to detect breast cancer, it was not until this procedure could capture the image on film was early detection possible.

Finding smaller, usually more localized breast cancer spurred many doctors to experiment in less extensive breast surgery than the radical mastectomy. Controversially – at the time – some doctors started to practice a two-step approach to breast cancer treatment: 1) biopsy to confirm a diagnosis and 2) confer with patient before starting a treatment regime. This soon led to a substantial change in breast cancer treatment and patient participation.

In June 1974, Rose Kushner, a 45-year-old journalist, felt an “elevation” in her left breast. Kushner struggled to find a doctor who would only perform a biopsy – most doctors refused to separate a biopsy from an immediate radical mastectomy. Her family surgeon finally relented and confirmed a breast cancer diagnosis.

After researching breast cancer treatment options, Kushner decided she preferred a less invasive procedure than a radical mastectomy. Unable to find a surgeon near her home in Maryland, she traveled to Buffalo, NY where Dr. Thomas Dao performed a modified, less invasive, mastectomy (lumpectomy).

Breast Cancer- A Personal History and Investigative ReportUsing her journalist skills, Kushner became a tireless advocate for breast cancer. In just seven weeks Kushner wrote Breast Cancer: A Personal History and Investigative Report, which challenged an often times paternalistic medical culture in America. Kushner asserted every woman should know three things.

    • The 1-step radical mastectomy was not current with medical knowledge.
    • Cancer specialists provided superior care to general surgeons.
    • Women must educate themselves about their disease, participate in the decision-making process and not be fearful of challenging their doctors.

These were radical notions in 1975. By 1979 the National Institutes of Health (NIH), in a conference on breast cancer, concluded the radical mastectomy was no longer appropriate for every breast cancer diagnosis. Kushner pushed the panel to go further and to reject the 1-step procedure – enabling women to make informed decisions about their treatment plan.

The same time period also saw conclusive, evidence-based studies that proved adjuvant systemic therapy (chemotherapy, hormonal therapy, radiation therapy) increased survival. The combination of early detection, additional treatment options and the fierce determination of patient advocates like Rose Kushner provided breast cancer patients more information to make choices.

This led to multi-disciplinary teams (oncologists, pathologists, radiation oncologists, radiologists and surgeons) participating in breast cancer treatment plans. The first freestanding center to combine different breast cancer specialists in one practice was the Van Nuys Breast Center (VNBC), founded in 1979 by Melvin Silverstein, M.D.

In a few short years breast cancer diagnosis and treatment had changed radically from a one-physician surgical disease to a much more complex disease that required a multidisciplinary team. — Breastlink founder John Link, M.D.

The History of Breastlink

Building upon his experience starting one of the first comprehensive breast cancer diagnostic and treatment centers in the US in the mid 1980’s (Long Beach Memorial Breast Center), John Link, M.D. founded Breastlink in 1995.

While there are different comprehensive models (physician-owned, academic or university, hospital based, etc.), our providers came to believe the best way to ensure optimal patient results was to have a free-standing, multi-disciplinary breast cancer practice. A local network of breast-dedicated providers is able to offer patients the benefits of sub-specialty medicine without the cost structure and legacy interests found in many hospitals and/or universities.

Breastlink has a long history with clinical research and trials. In the late 1980’s one of our patients, Lynette C., had advanced Her-2-gene-overproducing breast cancer. The cancer had spread to her liver and she was near death. Our providers, working with Dr. Dennis Slamon, an oncologist at UCLA, and Genentech, were able to secure Lynette as one of the first Herceptin human subjects. After eight treatments a scan of her liver revealed the cancer spots had decreased.

What had been a theoretical exercise, based upon an observation about the differences between the normal and abnormal genetic structure of a breast cancer cell, had led to the development of a viable new treatment for this particular type of breast cancer. – Dr. Link.

History of Breast Cancer | BreastlinkCommunication between patients and Breastlink providers is one of the major reasons patients refer friends and colleagues to our centers. Dr. Link, recognizing the need to increase awareness in society about the changing nature of breast cancer treatment, published the first edition of The Breast Cancer Survival Manual in 1998. The Manual is now in it’s 5th edition and has helped patients all over the world.

Breastlink soon grew from its roots in Long Beach. In 1998 a breast cancer center in Fountain Valley (Orange County) was opened. In 2005 our center based in Torrance was moved to Manhattan Beach.

In 2008 RadNet, the largest provider of outpatient imaging centers in the United States, purchased Breastlink. Our Fountain Valley clinical offices were moved to the city of Orange, where we joined forces with The Breast Care and Imaging Center of Orange County (Breast Care).

John West, M.D., a noted breast-dedicated surgeon, founded Breast Care in 1988. A general surgeon by training, Dr. West started Breast Care after his extensive experience building Orange County’s first regional trauma center that emphasized a comprehensive approach to assess and treat patients with trauma cases. Dr. West identified that patients afflicted with breast cancer would benefit from a multidisciplinary team approach:

In other breast care organizations, the breast imagers, surgeons and oncologists have their own independent practices. At our center, the physicians and providers are united into a single organized team, which leads to more efficient care and better communications. Our team is under the same roof, and utilizes a single management team, which works side by side with each other everyday. – Breast Care Founder John West, M.D.

This new partnership with RadNet allowed us to increase our capacity to handle imaging services, improve the quality of imaging reads and to expand our model of community-based breast cancer centers to new areas in Southern California.

Important aspects in providing optimal care are the willingness to learn from others in the breast cancer community and working with outside organizations to find the right clinical trial for our patients. Some patients do not know they may qualify for a clinical trial. We take great pride in working with patients to learn about them to see if they may qualify, and if they would potentially benefit, from a clinical trial. For more than 25 years many of our medical providers have worked with research programs such as:

  • The National Surgical Adjuvant Breast and Bowel Project (NSABP).
  • Southwest Oncology Group (SWOG).
  • The Cancer and Leukemia-Group B (CALGB).
  • Many others, including pharmaceutical firms and biotech partners.

Our Future

While we are a committed supporter of the Breast Cancer Deadline 2020’s goal to end breast cancer by 2020 we remain focused on providing detection and treatment to patients who need our help today – and every day until the medical knowledge exists to permanently end breast cancer.

The compassion and knowledge of the Breastlink team has helped us successfully treat thousands of patients. This experience will lead us to better treat future patients as we incorporate the:

  • Most advanced image modalities available.
  • Latest surgical procedures.
  • Most current trends in medical oncology.
  • Promising clinical trials discovering targeted therapies, targeted diagnostics and more oral chemotherapy agents.

We will never stop searching for better ways to detect and treat breast cancer. Every patient has a unique story and requires a personalized treatment plan. We look forward to the opportunity to help the needs of breast cancer patients today and tomorrow.
History of Breast Cancer References

  • Kushner, R. Breast Cancer: A Personal and an Investigative Report. New York, NY: Harcourt Brace Jovanovich; 1975.
  • Link, J., Waisman, J. and Link, N. The Breast Cancer Survival Manual, Fifth Edition. New York, NY; Henry Holt and Co.; 2012.
  • Link, J. Take Charge of your Breast Cancer: Lessons for Healing. New York, NY; Henry Holt and Co.; 2002.