Don’t Get Duped: What Should Happen During a Breast Exam

Say, you get to talking to a woman at a bar. She says she’s a plastic surgeon, and tells you she does breast surgery. She even offers to do a medical exam in the bar restroom. During the exam, she utters some medical terms and touches your breasts as a real doctor would.

But she’s not a real doctor. The number she gives you is for a real medical practice, but she doesn’t work there. Police figure out what’s going on when that practice gets calls from women asking to schedule an appointment with the nonexistent doctor.

This is what happened in Idaho just a few weeks ago. Boise police have since arrested the woman suspected of pretending to be a doctor — a 37-year-old transgender woman named Kristina B. Ross — and she is being held on felony charges of unlicensed practice of medicine.

While you could go your whole life without being approached in a bar for a breast exam, it’s still important to be careful when selecting a doctor for surgery, said Dr. Alan Gold, who practices in Great Neck, N.Y. and is the past president of the American Society for Aesthetic Plastic Surgery.

“Your investigation should start long before you get into the office,” Gold told MyHealthNewsDaily.
You should feel comfortable and safe with the surgeon you choose, and he or she should have a good track record and be board-certified, he said.

While, there’s no standard way to give a breast surgery consultation, the consultation should always take place in a doctor’s office, Gold said. In his practice, Gold first talks to his fully-clothed patients about surgery options and alternatives, before doing the breast exam.

“It’s important to get a feel for the patient as a person, so I’ll have them tell me a little about themselves before getting into whatever it is” they want done surgically, he said.

Here are some other things to consider if you’re thinking about surgery:

Seek a qualified doctor

Patients should seek out the doctor – not the other way around, said Dr. Anees B. Chagpar, a professor at Yale University and director of the Yale-New Haven Breast Center at Smilow Cancer Hospital in Connecticut.

“It’s not like a surgeon should go up to you on the street or at a bar, and say, ‘Let me give you a breast exam,'” Chagpar told MyHealthNewsDaily.

Gold recommends looking for doctors recommended by a family physician or a friend who’s had plastic surgery. It’s wise to choose a doctor certified by the American Board of Plastic Surgery, who has training in the surgery and works at an accredited hospital or doctor’s office, he said.

If the procedure will be done in his or her private practice, it’s important to ask if the doctor has hospital privileges, and could perform the procedure in a hospital instead if they wanted to, Gold said.

A doctor without hospital privileges could be a red flag, he said.

Physician operating outside the scope of their practice or training do not have privileges to do a surgery at a hospital, but they may do it in their offices where there’s no oversight, he said.

For surgeries other than plastic surgery, Chagpar recommends going to the American College of Surgeons website to see whether your surgeon is a member. She also advises going to a reputable center, such as a hospital affiliated with a university.

Get a proper examination

Medical students are taught to walk patients through every step of breast exams, Chagpar said. One of the core tenets of medical professionalism is making sure the patient feels at ease.

In a typical breast examination (not for plastic surgery), the doctor will examine the lymph nodes in the neck and armpit to check for lumps, she said. And most will examine the breasts while you are sitting up or lying down, with your hands over your head and then down by your side.

The doctor will palpate the breast to check for lumps from the collarbone down to the sixth rib, then from the breast bone in the center of the chest to the armpit, Chagpar said.

A doctor may choose how frequently during the exam to tell the patient what he or she is doing, but all doctors are “taught to make patients feel comfortable, and part of that is informing your patient about what you’re going to do,” she said.

Gold stressed the importance of feeling comfortable during the initial exam.

“It doesn’t get better,” later on, he said. “It’s a matter of being comfortable with the credentials and the operation you see around you, but also with the physician.”

With plastic surgery consultations in particular, a doctor should always inform you of the risks of the surgery, Gold said. And it’s never a bad idea to get a second opinion, he said.

“A red flag is if the doctor does not discuss recovery or how to minimize your recovery time, or if they do not discuss the complications, the potential risks, or if they don’t discuss any alternative treatments,” Gold said.

Follow MyHealthNewsDaily staff writer Amanda Chan on Twitter @AmandaLChan.

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