21 May 2018
When Dr. Alice Police was growing up in California, she wanted to be a cowgirl.
It wasn’t until she attended college at Point Loma College in San Diego that she developed an interest in science, which eventually led to medical school at Loma Linda University and then surgical training at the University of Southern California and the University of California, Irvine.
Now the Regional Director of Breast Care for Northwell Health in Westchester County, Dr. Police says of her work as a breast surgeon, “You’re always a student, and learning is so much fun.” For the past 30 years, Dr. Police has found inspiration and unwavering purpose from the lifelong learning involved in being a surgeon and the relationships she has with her patients.
Starting out as a general surgeon in 1986 – before there was such a thing as breast surgeon specialists, she gradually gravitated toward breast surgery as it became a subspecialty, and has been performing only breast surgery since 2005.
“I enjoy being able to make patients feel better,” states Dr. Police. “There’s a lot of psychology that goes into breast cancer. Unlike other diseases, it cuts across all facets of life – job, work, intimate relationships, and relationships with children.”
The multidisciplinary aspect of breast surgery is also an intellectual challenge. Breast cancer is complex and, in addition to surgery, it requires thinking about medical oncology, radiation oncology, and genetics.
Dr. Police, a parent to two grown children, moved here from California in late 2017. “The thing that drove me here is the opportunity to build a program. I have done that twice before [in California]. I will coordinate a multidisciplinary team, making sure the appropriate technologies are here,” says Police. “Being able to do that across two hospitals is a really fun and exciting challenge.”
Dr. Police will help implement three new technologies at both The Breast Institute at Northern Westchester Hospital in Mount Kisco and the Northwell Health Cancer Institute at Phelps Hospital in Sleepy Hollow. She has already been using these technologies for several years.
The Savi Scout uses radar technology in the case of a lumpectomy (partial removal of a breast). Instead of having an additional procedure the day of surgery to place wires to mark the tumor’s location, the Savi Scout can be placed weeks or months ahead of time. It is more precise and can prevent the possibility of a second surgery for a patient. Dr. Police was the first person in the country to put a Savi Scout in a patient post-FDA approval.
A MarginProbe is used for lumpectomies also. It is the only way to look at the margins (edges) of the tumor during the breast operation. If the cancer margins are not clear, the issue can be addressed immediately and, again, the patient is less likely to need a second operation.
Dr. Police has been using intraoperative radiation therapy (IORT) for over 15 years for early stage breast cancer. Instead of undergoing six weeks of daily radiation therapy after surgery, a patient is treated with a higher dose of radiation to a smaller area for 30 minutes during their surgery. According to Police, the toxicity to the heart and lungs is lower than traditional radiation and IORT has a better cosmetic result for the patient.
“I am extremely proud of our increasing use of technology to make a better operation – combining the three new technologies. I’m also proud of the ability to program-build and build a team that takes better care of a patient.”
Dr. Police notes that while breast cancer appears to be increasing in incidence, the mortality rate for breast cancer is down. She says most patients do very well now. One of her greatest challenges is convincing patients they do not have a death sentence. She says, “Ninety to 95% of the time, they are going to be just fine. They are going to do better than they think they will.”
While these technologies have changed breast surgery significantly, she believes the biggest change in breast cancer treatment over the past 20 years has been in genomics, which involves looking at the biology of a tumor.
Breast cancer had been thought to be a dozen different diseases. Police says that’s no longer the case. It has been found to actually be 150 different diseases. This has changed doctors’ entire approach to chemotherapy. Surgeons do not rush to operate anymore. First, they must figure out if a patient needs chemotherapy or not. “It requires a much more coordinated effort between the different disciplines,” explains Dr. Police. And treatment is more individualized because there are now tests that look at the genetic make-up of the tumor and tailor chemotherapy to that tumor.
Dr. Police will be taking her love of learning to the next level at both of the Northwell hospitals in Westchester. She is committed to teaching the next generation by reviving the breast fellowship at Northern Westchester Hospital and at Phelps. This fellowship will include a year of training for a general surgeon so she/he can become a breast surgeon. Dr. Police believes, “It’s not just about taking care of this community. It’s about training another person to take great care of their community.”