CONTACTS 
0201 - Stanford Medical Center                                                                                                                                            O-00000837 0706
020101 - Dr. Alice (Ellie) Guardino, MD, PHD                                                                                                                              O-00000837 0706
020102 - Assistant Professor Brest Oncology
020104 - Department of Medicine
020105 - Cancer Center                                                                                                                                                    O-00000837 0706
0202 - University of California San Franci                                                                                                                                O-00000835 0703
020201 - Dr. Christopher C. Benz, MD                                                                                                                                      O-00000835 0703
020202 - Professor of Oncology
020203 - Medical Oncology Department                                                                                                                                      O-00000835 0703
020204 - Mr.  FirstName                                                                                                                                                   O-00000835 0703

SUBJECTS
Report to Doctor Guardino on Millie's Progress Implementing 2nd Opin
2nd Opinion Received Stanford Assessment and Plan Diagnosis Patient

1204 -
1204 -    ..
1205 - Summary/Objective
1206 -
120601 - Follow up ref SDS 11 0000.
120602 -
120603 - Notified Doctor Guardino about favorable results implementing second
120604 - opinion recommendations on surgery. ref SDS 0 3H5X  Cite Peggy's good
120605 - fortune under the doctor's care. ref SDS 0 3A3P  Notified Doctor Benz
120606 - of Millie's strong recovery following recommendations in the doctor's
120607 - second opinion, ref SDS 0 G36K, including referrals to surgical
120608 - specialists. ref SDS 0 GN4P
120609 -
120610 -     [On 051109 letter to Doctor's Bailey, Grissom, and Shim commending
120611 -     contributions in recent 2nd opinions that guided Millie's
120612 -     treatment, and notifying of favorable results. ref SDS 14 QG6H
120613 -
120614 -
120615 -
120616 -
120617 -
120619 -  ..
1207 -
1208 -
1209 - Progress
1210 -
121001 - Commend Doctor Guardino at Stanford Cancer Center for Good Advice
121002 -
121003 - On 051008 Peggy called and we learned that she is being treated for
121004 - breast cancer by Doctor Guardino at Stanford, ref SDS 11 KS7G, who had
121005 - previously filed a 2nd opinion in Millie's case, received on 051209.
121006 - ref SDS 4 0001  The doctor's 2nd opinion work product for consultation
121007 - on 041019, ref SDS 2 0001, later led in part to Millie considering
121008 - mastectomy surgery on 051021. ref SDS 12 526H  The purpose of this
121009 - letter is to commend the doctor on results of her work helping Millie,
121010 - and to express confidence that Peggy will get high quality treatment.
121012 -  ..
121013 - Since Stanford does not support working intelligently, had to send a
121014 - conventional letter through the US Post Office system.
121016 -  ..
121017 - Submitted ref DIT 1 0001 to the doctor saying...
121018 -
121019 -    1.  We have been planning to report Millie's progress, but relapse
121020 -        and treatment have delayed response.  A few weeks ago, we were
121021 -        saddened hearing that our very close friend has breast disease.
121022 -        Millie and Peggy met in the 1970s, when both were promoted to
121023 -        account executives for major textile manufacturers, and so
121024 -        became pioneers charting a new career path for women.  With
121025 -        this long and special bond, we are heartened that you have the
121026 -        lead managing Peggy's care. ref SDS 11 KS8H, and were very
121027 -        pleased to assure her on your commitment to excellence.
121029 -  ..
121030 - Doctor Guardino's commitment to excellence is demonstrated by
121031 - insisting her assistant verify accuracy of even inconsequential data,
121032 - reported on 041019. ref SDS 2 BV92  The doctor took the time to
121033 - examine original test materials, which was not done at UCSF.
121034 - ref SDS 2 ER8O  Additionally, the doctor's 2nd opinion received on
121035 - 041209 was well written, and had very few errors. ref SDS 4 0001
121037 -  ..
121038 - Letter to the doctor continues...
121039 -
121040 -    2.  Millie has good news.  On October 27th, the doctor advised
121041 -        that, following mastectomy surgery, testing shows Millie is
121042 -        disease-free. ref SDS 13 M58G  This seems quite a miracle, and
121043 -        Millie appreciates that disease may recur.  For the time being,
121044 -        we are grateful she is off treatment and recovering well.  In
121045 -        sum, Millie's Kaiser team synthesized your recommendations for
121046 -        surgery, with ideas from Doctor Benz at UCSF on systemic
121047 -        treatment.  Scope of surgery was guided by recent second
121048 -        opinions from Doctors Grissom and Bailey.  Treating stage IV
121049 -        and secondary IBC with surgery, when there is no evidence of
121050 -        disease, suggests Millie may provide yet another example for
121051 -        helping others. ref DIT 1 NO6O  Many lessons learned emerge
121052 -        from Mil's patient history. ref SDS 8 6L4M
121054 -         ..
121055 -    3.  Again, it was a great pleasure working with Stanford Medical
121056 -        Center, and thanks very much for outstanding work product in
121057 -        your second opinion.  Peggy is fortunate to be in good hands.
121058 -        ref DIT 1 NO81
121059 -
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121062 -
1211 -

SUBJECTS
Report to Doctor Benz at UCSF on Millie's Progress Implementing 2nd

2403 -
240401 -  ..
240402 - Commend Doctor Benz at Stanford Cancer Center for Good Advice
240403 -
240404 - On 041117 Doctor Benz recommend there is no role for surgery to treat
240405 - Millie. ref SDS 3 OU5P  On 050729 primary care physcian recommended
240406 - immediate surgery. ref SDS 7 BZ56  On 050819 Doctor Benz was asked for
240407 - a 2nd opinion on surgery, in light the prior opinion that surgery is
240408 - not a good solution for Millie. ref SDS 9 PB4O  On 050823 UCSF
240409 - responded that Doctor Benz refused comment, and made referral to
240410 - Doctors Grissom and Bailey. ref SDS 10 AI8N
240412 -  ..
240413 - Submitted ref DIT 2 0001 to Doctor Benz via email to Sheridan Tinker,
240414 - with copy to Margaret Rubino, following up Margaret's letter on
240415 - 050823. ref SDS 10 AI8N
240417 -  ..
240418 - The letter to Doctor Benz says...
240419 -
240420 -    1.  On July 27th, Millie's primary care physician recommended
240421 -        mastectomy following favorable response to treatment with
240422 -        Taxotere and capecitabine, which you had recommended late last
240423 -        year.  Since testing showed no evidence of continuning disease,
240424 -        due diligence required asking for follow up comment, based on
240425 -        your opinion stating there is no role for surgery in her case.
240426 -        UCSF reported on August 23rd that you made referral to Doctors
240427 -        Grissom and Bailey for surgical expertise. ref DIT 2 0L5N
240429 -         ..
240430 -    2.  Millie got excellent support from Grissom and Bailey, relying
240431 -        in part on your prior opinion, ref DIT 2 H66M, and leading to
240432 -        surgery on October 21, that implemented proposals for an
240433 -        innovative solution. ref SDS 12 MP8K
240435 -         ..
240436 -    3.  Good news - on October 27th, Kaiser advised that testing shows
240437 -        Millie is disease-free. ref SDS 13 0001  Today, we learned that
240438 -        her CA 15-3 cancer marker has suddenly and dramatically dropped
240439 -        to 34, down from 45 the past three (3) months; 34 is by far the
240440 -        lowest level in Millie's four (4) year ordeal.  This seems
240441 -        quite a miracle! ref DIT 2 NO6O  Millie appreciates that
240442 -        disease may recur; but, for now, we are greatful she is off
240443 -        treatment and recovering well.  In sum, recovery was
240444 -        accomplished by implementing your ideas on systemic treatment,
240445 -        (beginning on 050329, ref SDS 5 T58M], and when testing
240446 -        eventually showed no evidence of disease, Kaiser proposed
240447 -        surgery. [on 050610, ref SDS 6 XQ41]  Treating a stage IV
240448 -        patient for secondary IBC with surgery, when there is no
240449 -        evidence of disease, suggests Millie may provide lessons
240450 -        learned from patient history. ref SDS 13 XA5N
240452 -         ..
240453 -    4.  Congratulations for playing a pivitol role in Millie's
240454 -        recovery.  You and UCSF deserve a well done for quality advice
240455 -        on treatment and referrals, demonstrating personal and
240456 -        organizational integrated management. ref DIT 2 H683
240458 -         ..
240459 -    5.  If time permits, please comment on biopsy of surgical tissue
240460 -        finding DCIS [reported on 051027, ref SDS 13 615K, and in
240461 -        relation to Kaiser's report of disease-free status. ref DIT 2
240462 -        PPVS
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