Multidisciplinary Breast Cancer Clinic
Mikki Machalinki was just 11 years old when she lost her mother to leukemia, so her diagnosis of breast cancer in 2007 was especially challenging. At 36, Mikki’s youngest son was just a year old whe ...
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The Multidisciplinary Breast Cancer Clinic at The Regional Cancer Center brings together a team of specialists to provide a comprehensive approach to the evaluation and treatment of patients with breast cancer.
The primary goals of the clinic are (1) to offer innovative diagnostic and therapeutic strategies specific to each individual patient’s diagnosis, and (2) to facilitate the gathering of multiple opinions from various clinical specialists.
Developing an effective treatment plan for breast cancer can involve input from a variety of specialists. For many patients the time from diagnosis to the start of treatment can be frustrating and lengthy.
To expedite development and implementation of a treatment plan, The Regional Cancer Center collaborates with a multidisciplinary team of specialists in surgery, medical oncology and radiation oncology.
Patients benefit from a “navigation” system developed to provide patients key contacts in the continuum of care. Breast care coordinators keep in touch with patients while their treatment plan is developed. Diagnostic studies may be delivered by various breast specialists in more than one location. Physicians evaluate the patient, review diagnostic testing, and discuss each patient’s case to determine the best course of action for treatment. Treatment plans involving various specialists are developed that meet each patient’s unique needs.
Surgeons from UPMC Hamot and Saint Vincent Health System who have expertise in breast cancer compliment the multidisciplinary team. Advanced surgical techniques, such as oncoplasty, are used as appropriate. Time is spent with each patient to tailor a surgical plan that meets each patient’s needs and desires. Surgical procedures are performed at the hospitals. In particular cases surgeons collaborate with radiation oncologists by preparing the surgical site for partial breast irradiation (link) to target delivery of radiation to the tissue directly surrounding the original tumor site -- the area of the breast where cancer is most likely to recur.
Medical oncologists with expertise in breast cancer offer a full range of chemotherapy and biologic targeted therapies for all types and stages of breast cancer. Patients have access to the latest therapies and clinical trials. For women with certain early-stage breast cancers Oncotype DXR (link) can be used as a diagnostic test that contributes to treatment planning. When appropriate, patients are placed on a clinical pathway, a disease-specific treatment strategy developed by UPMC Cancer Centers physicians, to ensure that all patients receive the same evidence-based care. Innovative and promising clinical trial options are pursued along with the best standard of care therapies.
Radiation oncologists at The Regional Cancer Center are experienced in the use of conventional radiotherapy, 3D radiotherapy, intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT). For certain cases, brachytherapy (internal radiation) may be prescribed. Brachytherapy involves the use of radiation-producing materials placed inside the body to attack cancer. The radiation oncologist leads a team of professional that administers the high dose rates using a Nucleotron. When brachytherapy is used in the treatment of breast cancer it is sometimes referred to as partial breast irradiation.
A Personalized Approach
Breast cancer treatment can take a significant toll on patients and their families. To ease this burden a nurse coordinator serves as a point person for the treatment team, working with each patient and their family to guide them through every step of the diagnosis and treatment initiation. A social worker, palliative care nurse, dietician, and financial counselor are additional resources for clinic patients. The nurse coordinator reviews each patient’s history and makes appropriate appointments based on the patient’s needs and the team’s recommendations.
What to Expect At Your First Appointment
- Enter The Regional Cancer Center at the main entrance.
Reception staff will establish your patient record and verify related information.
- Plan to be at the Center for up to two hours.
You may be seen at this visit by two physicians, one at a time, for approximately 30-45 minutes each. During this time you may also meet with a nurse, social worker or dietician, if necessary.
- We encourage you to bring someone with you to your appointments.
A second set of ears and someone to take notes on what is discussed can be very helpful.
- Each visit will consist of a consultation and discussion.
Aspects of treatment and side effects will be reviewed in detail.
- We encourage you to ask questions.
Understanding the treatment process is the way to overcome any fears and concerns you may have.
- If you are seeing more than one physician, prior to your visit the physicians involved in your care will meet to develop a plan of treatment they agree will be the best for you.
This plan will be reviewed with you by each physician and with your input will be finalized.
- If you are seeing more than one physician, your insurance may require you to pay a co-pay for each physician appointment during this single visit to the cancer center.
The patient accounting statement you receive in the mail from The RCC will detail the co-pay deductions required by your insurance plan.
- Before you leave the nurse coordinator will review with you your plan of care and an estimated timetable for your treatment.
She will work with you to set your next appointments for treatment and answer any further questions you may have.
Services Provided by UPMC Cancer Centers
The vast majority of cancer diagnostic and treatment modalities being offered today are available at The Regional Cancer Center. For the few types of treatments not provided, the physicians at RCC will coordinate a treatment plan with specialists at UPMC Cancer Centers, one of the top academic cancer programs in the country. Effective management of more unusual cancers and coordination of any subspecialty care that may need to be provided in Pittsburgh is enhanced by close working relationships between our organizations. Our shared goal is making these instances as seamless as possible for patients, while providing as much care as possible close to home. Talk with your doctor at RCC to understand if such services may have a role in your care plan.