Return to Main Menu

Comprehensive services key to breast cancer patients by Cindy Abole Public Relations                  At MUSC, newly diagnosed breast cancer patients can reap the benefits of receiving a comprehensive, focused approach to their care starting from early detection to recovery.   Hollings Cancer Center breast care team nurses Bonita Gotbaum, from left, breast oncology coordinator; Kathi Callahan, surgical oncology coordinator; Amy McCurley, Mobile Health Unit coordinator; and Debbi Bryant, nurse navigator, discuss the advantages of comprehensive breast cancer care with patient-survivor Lenora Himmelstein. This coordinated team approach already helped thousands of cancer survivors through a combination of careful, immediate evaluation and diagnoses to the use of modern technology and shared expertise that allowed them to resume fuller, healthier lives.   With cancer, numbers don’t lie. It’s estimated that on average, one out of seven women will be affected by breast cancer at some point in their lifetime. In South Carolina, the news is even graver. The American Cancer Society reports that the Palmetto state has one of the highest age-related death rates for breast cancer in the country.   In the case of most cancers and other life-threatening diseases, the rate of survival can improve  thanks to early detection and diagnosis, plus quick access to specialized care, according to Megan Baker Ruppel, M.D., breast surgeon and assistant professor in the Department of Surgery. In addition patients are offered a full range of clinical services as found within a comprehensive cancer center, and they also benefit from better clinical outcomes.   “I’m impressed with the cohesiveness of our breast health team,” said Ruppel, referring to the Hollings Cancer Center’s comprehensive breast care team of physicians, nurses, surgeons, radiation oncologists, breast plastic surgeons, physical therapists, genetic counselors, clinical psychologists and other specialists.   “Our breast care team is very interested in improving patient experiences so we take everything we do to heart,” Ruppel said. “Our focus is always with our patients. We strive to provide as many options available to them or explore new ways that can help improve their experiences.  That’s why we’ve introduced scheduling improvements for patients and providers through our 24-hour breast cancer hotline and offer convenient, one-stop services for patients during their visits, plus other services.”   Since 1993, MUSC has maintained comprehensive breast care services to its patients. Today, these services are extended to all Lowcountry physicians and their patients. The expanded services include the addition of new medical specialists, coordinated medical and surgical oncology and pathology services, expanded research and clinical trials, and use of newer breast imaging technologies. The value of multidisciplinary input continues to make a positive impact on patient outcomes.      “We appreciate the partnership we have with referring physicians in the community,” Ruppel said, referring to the triage component following a patient’s self assessment and physician’s diagnosis. “We can provide the patient with a speedy evaluation, usually within one to two business days and often, quick diagnostic assessments when indicated with results in 24 hours. So far, its worked well for everyone. The feedback we’ve received from physicians and patients has been positive.”      In the area of technological improvements and treatment options, MUSC remains at the cutting edge. The center has established a foundation in the areas of state-of-the-art imaging, radiation therapy and stereotactic biopsy. Since 2003, MUSC provided digital mammography services as one of the most advanced mammography technologies available today.   Last May, MUSC became the Lowcountry’s first complete digital imaging center with the unveiling of four full field digital mammography units at Rutledge Tower and the Hollings Cancer Center. Additionally, MUSC is the only center in the Lowcountry to provide partial blast breast radiation—MammoSite radiation therapy—under protocol. Under the guidance of nationally-recognized expert Buddy Jenrette, M.D., professor and chairman of the Department of Radiation Oncology, certain patients can receive condensed radiation treatments directed to tissue surrounding a tumor at a portion of the typical treatment protocol.   Patients also benefit from the center’s high-risk breast program, which provides advanced genetic screening, detection and treatment for women with a family history of breast or ovarian cancer and who may be considered at high-risk for breast cancer. Patients can also gain from continual screenings, risk assessments, personalized surveillance plans, psychosocial support and other services.      Patients seeking information on HCC’s breast cancer clinical trials will benefit from the depth of expanded trials offered in the areas of radiation oncology, surgical and medical oncology. MUSC retains memberships with numerous national organizations that host these ongoing National Cancer Institute-sponsored center trials including the Southwest Oncology Group, American College of Surgeons Oncology Group, National Surgical Breast and Bowel Project and the Radiation Oncology Group.   Other investigator-initiated studies for breast cancer are currently under development and guided by Alberto Montero, M.D., assistant professor, Division of Hematology/Oncology, formerly a clinical researcher at M.D. Anderson Cancer Center. MUSC is also the primary site for the Minimally Invasive Molecular Stating of Breast Cancer or MIMS trial, one of the largest, multi-site trials that evaluates the molecular diagnosis of breast cancer.   Among the center’s newest initiatives to promote prevention, education and  awareness is the Wachovia High-Risk Breast Cancer Initiative and Avon Patient Navigator Program. The Wachovia initiative is a five-year statewide program that helps identify women at high-risk for breast cancer. Geared towards patients and physicians, it provides information on risk factors, assessment tools and breast surveillance strategies. The Avon program introduces the services of patient navigator support staff that assists practitioners by assessing a patient’s needs throughout their care. The program is especially helpful to underserved and underinsured patients.   “MUSC strives to be comprehensive but compassionate in the way we deliver care and services to our patients,” Baker said. “At a time when the interest and focus may be on technology, research and trials, it's easy to lose sight of focusing on the patient. At MUSC, all of us try very hard to be a team that is supportive to patients, their families and focused on improved quality of life.” Patient shares “good feelings” Life was great for 74-year-old Charleston transplant Lenora Himmelstein. A Philadelphia native, Himmelstein and her husband relocated to the Lowcountry several years ago to be close to her daughter and family.   Last June, she discovered a small lump in her left breast while conducting her monthly self-breast exam. She  thought it was nothing feeling reassured that she received a clean mammography screening just a couple months before.   Upon seeing her internist, Ben Clyburn, M.D., she was referred that same day to Ruppel. After a careful evaluation, Ruppel conducted a biopsy and confirmed it to be malignant. Worried but not devastated, Himmelstein conferred with her physicians to consider treatment options and establish a plan of care.   “I’m grateful that it was caught early so that there were many options for my care and treatment,” said Himmelstein. “From the start I placed tremendous faith in my physicians and their care for me. I had a good feeling that everything was going to be OK.”   Within weeks, she was scheduled for surgery and subsequently received follow-up radiation therapy.   “I didn’t cry once,” boasted Himmelstein, following six weeks of radiation therapy. “The physicians, caregivers, staff—everyone was terrific. They made it a positive experience for me.”   Today, she’s cancer free but under observation with Hollings Cancer Center specialists. Following her recovery, she was enrolled in the high-risk breast program and evaluated by a genetic counselor. For Himmelstein, breast cancer runs in her family. Her mother was diagnosed at age 75 and her grandmother at 85. Tests conclude that she does not carry the cancer-producing gene.     Friday, Jan. 27, 2006 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778, ext. 201.