It Takes a Team

Group of doctors and clinicians meeting to discuss breast cancer cases.
Multidisciplinary Breast Program Provides Coordinated Cancer Care

The past decade has brought many advances in breast cancer treatments, including new surgical approaches, targeted medications, genetic testing, and precision radiation therapy. Often, patients must undergo multiple types of treatment in succession and receive follow-up care to ensure that the cancer does not return.

Columbus Regional Hospital (CRH) has designed a multidisciplinary care team approach to breast health and breast cancer care. Every week, the breast cancer care team assembles for an in-person conference to discuss all new breast cancer diagnoses and patients with complex cases. The team includes breast surgeons, oncologists, radiologists, pathologists, clinical pharmacists, social workers, and a breast cancer care navigator. 

 “By sitting down together with all specialties, we’re able to coordinate and customize each patient’s treatment,” said medical oncologist and hematologist Nadeem Ikhlaque, M.D. 

Professional head shot of Dr. Nadeem Ikhlaque. “We can discuss what type of surgery the patient needs, whether they require chemotherapy or radiation, and if hormone therapy or immunotherapy medications may be appropriate. All of these issues are discussed up front at the time of diagnosis.”

Directly after the meeting, the specialists meet with their patients in a series of consultations, all on the same day. Afterward, a breast cancer care navigator answers any remaining questions the patients may have and sets up the next appointments. “It’s a logistical convenience for patients and their families,” Dr. Ikhlaque said. Patients leave with a binder of information and clear understanding of their treatment plan.

Innovative Care

Some of the advanced treatments available at CRH include:

Precision surgery and reconstruction: Surgeons are able to take a targeted approach to tumor removal by placing a radio-frequency identification (RFID) chip at the tumor location during a mammogram to help guide the surgeon during the procedure. They also use a radio tracer dye to identify whether the cancer has spread to the lymph nodes and remove only what is necessary. Limiting lymph node removal can prevent lymphedema, a painful postoperative tissue swelling.

Professional head shot of Dr. David Thompson.“We also offer plastic surgery consultations immediately so patients know what their reconstruction options are,” said breast surgeon David Thompson, M.D. He added that lumpectomy is generally an outpatient procedure; mastectomy patients stay a night in the hospital. 

“We use a variety of pain control methods, including applying numbing medications directly at the surgical site, to help patients recover faster and ensure that they can get home as quickly as possible,” he said.

Genetic testing: Oncology pharmacist Kelsey Finch, Pharm.D., oversees genetic testing for inherited mutations that are associated with an increased risk for breast cancer. “We coordinate the patient’s testing, discuss how results may affect their breast cancer management and future cancer screenings, and aid in coordinating testing for family members who may be at risk for pathologic mutations,” she said.

Chemotherapy alternatives: For many patients, hormone therapy that lowers estrogen levels or stops estrogen from helping cancer cells grow can take the place of chemotherapy infusions. Aromatase inhibitor oral medications can also be used to treat hormone receptor-positive cancers. And some patients may benefit from immunotherapy medications, which train the body’s immune system to fight cancer cells.

“Chemotherapy is not warranted in every case,” Dr. Ikhlaque said. “We aim to provide treatments that are well tolerated and allow patients to maintain a good quality of life, with fewer side effects and a longer duration of response.”

Schedule Your Mammogram
Getting a mammogram is easy as 1-2-3. 
1. Log in to MyChart. 
2. Self-schedule your annual mammogram. 
3. Go to your appointment and pat yourself on the back for taking this important step toward preventive health.
 

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