Breast Care Center
with Lauren Schnaper, MD
What are the goals of the GBMC Breast Care Center?
The GBMC Sandra and Malcolm Berman Comprehensive Breast Care Center offers programs designed to diminish fear and eliminate myths surrounding breast cancer by offering realistic risk assessment, decreased waiting time for imaging and biopsy results, and expedited multidisciplinary cancer care.
Although all women over the age of 40 should have annual screening mammography, very few of those develop a problem requiring additional imaging or biopsy and of those, a smaller percentage will have cancer. A woman with a new abnormality on breast examination or on mammogram can seek an opinion from Breast Center radiologists and surgeons as to whether further imaging or biopsy is needed.
The most frequent complaints from women regarding breast problems are related to four time delays: those between screening mammography, call-backs for additional imaging, recommendation for biopsy, performing the biopsy, and receiving results. GBMC’s Rapid Diagnosis Program allows same-day evaluation and, in most cases, same day core needle biopsy using minimally-invasive mammogram, ultrasound or MRI guided techniques. The physical plant of the center supports the integrative approach joining radiology and the other services of the Breast Center. Housed within 8,000 square feet, the two areas are connected by the gowned waiting room. A patient can go from the imaging area to see her physician or in the opposite direction, to undergo needle biopsy, without changing her clothes. Depending on the pathology laboratory to which the biopsy specimen is sent, results can be returned within 48 hours. Traditionally, the time from the first screening mammogram to biopsy results is weeks or months.
If the biopsy reveals cancer, women can then be seen by their surgeon within a matter of days. Treatment plans are formulated and facilitated by a team of surgeons, plastic surgeons, medical and radiation oncologists, a clinical nurse and psychological support. The team confers regularly regarding ongoing cancer care and meets weekly with pathologists, internal medicine physicians, radiologists and support staff in a cancer case review conference. It is this attention to detail and participation in national clinical research trials that has helped make GBMC’s Cancer Center one of the 50 best cancer centers in the country, for a fourth time, according to U.S. News and World Report.
The Risk Assessment Program attempts to decrease the fear that women harbor regarding their risk for developing breast cancer by offering an accurate assessment of their true risk. It is well known among physicians that young women over-estimate their risk and older women under-estimate their risk of developing breast cancer. Women participating in the program answer questions regarding family history and other information using a computer tablet. The answers are automatically entered into several mathematical models that provide a numeric answer consistent with their risk. Most women will be relieved to know that their risk is lower than they expected and is no different from that of the general population. Others will fall into the category of slightly increased risk for developing breast cancer and may need a monitoring program. A few will be among those women with significantly increased risk and will then undergo genetic counseling and testing for one of the inherited breast cancer syndromes. A small percentage in this last group will require intervention consisting of medication or surgery.
The goal of the complementary programs of the GBMC Sandra and Malcolm Berman Comprehensive Breast Care Center is to provide patient-centered, efficient, sensible and comprehensive care for women with benign and malignant breast disease.
