THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Friday, March 8, 1996 TAG: 9603060138
SECTION: PORTSMOUTH CURRENTS PAGE: 03 EDITION: FINAL
SOURCE: BY IDA KAY JORDAN, STAFF WRITER
LENGTH: Long : 122 lines
A LITTLE MORE than a year ago, in December 1994, Dr. Robert B. Caplan of Portsmouth wrote a letter to the editor of General Surgeon News. It changed his life drastically.
``I always thought the written word was powerful, but I couldn't believe the response I got,'' he says.
Caplan, a surgeon who specializes in breast cancer, wrote the letter to make a case for surgeons performing a procedure known as a stereotactic core biopsy. He wanted to offset a push by radiologists to take over all the needle biopsies and cut out the surgeons.
From the day the magazine was delivered, he got 50 to 60 calls a day from surgeons across the country. The calls kept coming in.
Now Caplan's Breast Care Center on the first floor at 355 Crawford St. - the old Citizens Trust Building - is a training center for other surgeons. Every month about 20 come from many parts of the nation to Portsmouth for a one-day session to learn the procedure.
The office also houses the American Society of Breast Surgeons, a new organization started by Caplan that he says now has more than 200 members.
``Some of the best-known surgeons in the United States are members,'' Caplan says.
He travels a lot to talk to other breast surgeons.
Last weekend he spoke to 650 physicians at the Miami International Breast Conference. Next weekend he'll be in New York City to do a workshop on stereotactic core biopsy for the American College of Surgeons. Later this month, he'll travel to Montreal and then to Chicago to speak to others.
``I think I'm better known around the country than I am in Portsmouth,'' he said.
Caplan, who passed his 59th birthday Monday , says the stereotactic biopsy ``revolutionized the diagnosis of early breast cancer.''
Using a computer-guided X-ray device, Caplan says a doctor can locate a lesion in the breast accurate to a fraction of a millimeter. A 14-gauge needle then takes samples of tissue from the lesion that can be read the same way as open surgical biopsies.
The procedure, he says, is as accurate and specific as open surgery and ``much less painful and much less expensive.''
The patient experiences no physical discomfort, and there is no scarring after the procedure, Caplan says. And there are no restrictions on patient activity before or after the procedure.
Also, he says, the procedure is done in the surgeon's office and results are known much sooner than they are in the case of open surgery.
Caplan says stereotactic core biopsy costs one-third of what is charged for a surgical biopsy, a savings of about $3,000 per patient generally.
``I figure we have saved $750,000 to $900,000 for the system right here in a year.''
That, Caplan says, is very important.
``We simply can do it this way cheaper than anybody else. We can make better use of the equipment than radiologists and hospitals.''
One of Caplan's happiest days came when his organization, the American Society of Breast Surgeons, was asked to participate on an advisory committee for the FDA.
``The College of Radiology is trying to get the FDA to prohibit surgeons from using the procedure,'' he says. ``We don't need that to happen.''
Six months ago, Caplan decided he needed an experienced, in-house radiologist, and Dr. Paul Fisher, 42, joined the practice. Fisher had been director of imaging at Yale Medical School.
Robert Caplan is the son of Dr. Julius Caplan, who practiced medicine here for 45 years. Robert Caplan has a son, Eric, who is a first-year medical student at the University of Virginia, and another, Bryan, a business major at the University of Colorado.
Robert Caplan studied at the University of Virginia and at Cornell. He practiced general surgery in Colorado for 10 years before deciding he wanted to come home and open a practice.
``I heard Dr. (Lem) Mayo and then Dr. (Paul) Robinett were retiring. I bought Dr. Mayo's equipment 12 years ago, and then in 1986 I took over Robinett's practice.''
In 1990, Caplan decided to devote his time ``exclusively to breast disease.''
``My mother died of breast cancer when I was 13, and I think I always was interested in that field.''
Within a short while, he became interested in the stereotactic biopsy, took some courses and then visited the doctor in Denver who started using the procedure nine years ago.
Until last April, Caplan had offices at Maryview Medical Center.
The Breast Care Center on Crawford Street was designed by Caplan and his wife, Diane, who is a nurse in charge of patient counseling at the center.
``We needed more space to do what we want to do - offer complete breast care,'' he says. ``We have been very happy that we moved downtown.''
The office is on the ground level and is designed with patients in mind.
``I guess you would say this is my statement,'' Caplan says. ``This is the right way to do it.''
Caplan relishes his role as a maverick.
``If I weren't doing this, I'd be out crusading. I think I would be the Ralph Nader of medicine.'' MEMO: BREAST CARE CENTER A DOWNTOWN SHOWPLACE
The Breast Care Center is a show place for the Signet Bank Building
at 335 Crawford St., an eight-story structure built as headquarters for
the old Citizens-Trust Bank.
Over the years, the building has seen its up and downs. Now 96
percent occupied, its occupancy rate was barely over 50 percent three
years ago.
While Signet Bank still operates a branch on the first floor, the
bank has no other space in the 80,000-square-foot building. Renovations
have helped attract new tenants, says Manager John Profilet of S.L.
Nusbaum Realty Co. in Norfolk.
``We aren't finished yet,'' he says. ``We are redoing the soda shop
on the first floor right now, and we will be putting awnings on the
front of the building in keeping with the Olde Towne image.''
ILLUSTRATION: Staff photos by MARK MITCHELL
Dr. Robert B. Caplan works with the digital imaging equipment in his
Breast Care Center. Next weekend he'll be in New York City to do a
workshop on stereotactic core biopsy for the American College of
Surgeons.
Every month about 20 surgeons from across the nation come to the
Breast Care Center in the Signet Bank Building on Crawford Parkway
to learn Kaplan's technique.
by CNB