Gynecology Department Paracelsus Medical University

Transcription

1 Breast Center Gynecology Department Paracelsus Medical University international@klinikum-nuernberg.de

2 Dear Patient You were diagnosed with breast cancer, or there is a suspicious lump palpable in your breast. Being diagnosed with breast cancer can be a devastating experience. Though some people don t openly express how they feel, it is impossible to not be upset when told you have breast cancer. The mere diagnosis of suspicion for breast cancer causes tremendous anxiety. The probability of healing breast cancer has been greatly improved in recent decades through the introduction and optimization of multi-modal therapies and interdisciplinary treatments. Early detection of breast cancer is provided through mammogram screening services and advanced diagnostic screening tools including breast self-exams. Major treatment advances have been made in recent years and patients prospects are much more promising than they used to be. Today, women with early detected breast cancer have an approximately 90 percent survival rate. Survival time for breast cancer in other patients was significantly extended, maintaining high level of quality of life. We owe this to exciting advances which are paving to better treatments in fighting cancer. Depending on the type of cancer and tumor stage, our physicians dispose of much wider and more differentiated treatment options than they did twenty years ago. All members of the multidisciplinary and certified Breast Center team at Klinikum Nuernberg are committed to provid the highest quality of care and attention. At our Breast Center, we have multiple specialists in each discipline, so the recommendations for treatment are based on the consensus opinions of the group of specialists, with consultation from their colleagues in other specialty areas. Patient cases that would benefit from a team review are reviewed by our Tumor Board, which is a treatment planning approach where a number of specialists review and discuss the condition and 2

3 treatment options for a patient. Multiple scientific studies provide evidence that the real benefit of multidisciplinary cooperation approach and care is that the patient can get the opinion of a group of specialists and can feel more confident that they have explored all of their options. Benign breast conditions in women and benign breast disorders in men are treated the same with the highest quality of care and attention at our Breast Center. Prof. Dr. Cosima Brucker Chief, Department of Gynaecology and Director of the Multidisciplinary Breast Center Certified Breast Center The Breast Center at Klinikum Nürnberg is one among 255 designated comprehensive Cancer Centers in Germany and has held this designation since The Breast Center operates in full compliance with strict guidelines of the Deutsche Krebsgesellschaft (German Cancer Society [DKG]) and Deutsche Gesellschaft für Senologie (German Society of Senology [DGS]). The work-flow and qualitymanagement processes employed at the Breast Center are certified to meet DIN EN ISO 9001:2008 Quality Management Standards. The Breast Center is participating in the Breast Cancer Disease Management Program (DMP) in Bavaria and has the additional specific designation Brustzentrum (DMP) ( Breast Center [DMP]). 3

4 Our major services available, at a glance Treatment in full compliance with the guidelines of national and international standards Our Breast Center is a comprehensive, multidisciplinary breast care program, offering a full spectrum of clinical and support services, from screening and diagnosis to treatment, all housed within a serene, state-of-the-art facility (short distances to bridge, short wait times). We provide advanced medicine, based on high standards in advanced training and latest medical technology We provide innovative and high quality treatment techniques Access to emerging therapies via clinical trial enrollments We are committed to ensuring high-level safety and quality standards Patient cases that would benefit from a team review are reviewed by our Tumor Board, which is a treatment planning approach where a number of experts review and discuss the condition and treatment options for a patient We offer breast conservation surgery resp. reconstructive breast surgery We provide the most advanced treatment options, including intraoperative radiotherapy with Intrabeam (IORT) for breast cancer and sentinel lymph node technique We provide complete patient care beginning with the initial visit and ending with follow-up care programs We are committed to liaise closely with supportive care and support services We provide psycho oncological care to every patient who needs it Patient s appointments are coordinated all in one place We offer patients to participate in the Disease Management Program DMP for breast cancer 4

5 The Breast Center offers a Full Spectrum of Clinical and Support Services At our Breast Center, you expect the newest medications, advanced diagnostic procedures and innovative treatments. But what you will also find is a compassionate, patient-focused team of state-of-the-art technologists and highly skilled medical professionals who are exclusively devoted to the prevention, early detection and treatment of breast cancer ensuring a high level of quality. Complying with current national and international standards, all members of the breast cancer multidisciplinary teams are committed to providing patients the highest quality of care and attention during their time with us. This applies as much to diagnostics and treatment of breast cancer as to the treatment of benign conditions and breast development disorders. Our Breast Center offers a full spectrum of diagnostics and treatment of all breast diseases: Breast cancer (different types and stages, including second opinion) Benign breast conditions, including - Benign breast tumors - Large breast (breast hypertrophy) - Small breast (breast hypoplasia) Plastic and aesthetic surgery procedures - Breast reconstruction - Breast augmentation - Breast reduction Coping with illness and regaining control - Professional counseling for the psychological needs - Couples counseling and sexual counseling Counseling for individuals at high risk for breast cancer 5

6 Mammary Carcinoma diagnostics and therapy Diagnostics Diagnostic evaluation of breast cancer typically includes the newest mammographic technology, breast ultrasound, MRI, minimal-invasive automatic high-speed core-needle biopsy and stereotactic vacuumassisted breast biopsy. The breast cancer staging workup and TNM classification is performed complying with international standards in close cooperation with our inhouse Institute of Pathology. Having quick access to these expert diagnosticians at Klinikum Nürnberg, Campus North, is a great benefit to our patients. Histology analysis results are usually available after two days. Breast Cancer Treatment Breast cancer treatments are delivered in compliance with national and international guidelines and the current scientific standards. Individually tailored optimal combination of modern treatments for breast cancer are used, including: 6 Breast-preserving surgery Sentinel lymph node surger Radical mastectomy for breast cancer Intraoperative radiotherapy (using Intrabeam ) Antihormonal and bisphosphonate therapy Adjuvant and neoadjuvant therapy Chemotherapy (including treatment of possible side effects) Modern test procedures can guide the decision for prognostic assessment and help make decisions to individualized treatment (for instance gene expression testing) Radiotherapy (using radiotherapy treatment equipment of the latest generation, including radiotherapy planning systems) Oncoplastic breast reconstruction procedures (using tissue flap surgery with autologous tissue or breast implant)

7 Mammary Carcinoma diagnostics and therapy Generally, surgical removal of the tumor is the first step in treatment for breast cancer. This may not always be the case, treatment options may differ depending on the type of tumor and tumor stage. Which procedures in which order recommended for treatment are based on the consensus opinions of the multidisciplinary group of specialists at the Tumor Board, with consultation from their colleagues in other specialty areas. Every single step in the decision-making process is shared with the patient. No decision is made over the heads of patients, and patients will also not be pressured into a particular treatment option. Breast Preserving Surgery In order for a patient to be a good candidate for lumpectomy, we should be able to expect that lumpectomy will result in a breast with a good cosmetic appearance. Almost 90 percent of eligible breast cancer patients at our Breast Center have breast conservation surgery conserving a natural looking breast. The lymph node system is preserved as long as safety is ensured. When breast preserving surgery is not the safest option, it is often possible to use oncoplastic reconstructive techniques involving autologous microvascular free flap options or breast implants, in order to minimize the appearance of volume loss and to preserve a good shape. Your breast surgeon at the Breast Center and the breast plastic and reconstructive surgeon at the Department of Plastic and Reconstructive Surgery will help you decide which option is best for you. Radiation Therapy and Chemotherapy Klinikum Nürnberg provides, both radiation therapy and chemotherapy, under one roof. The Breast Care Nurse at the Breast Center coordinates patient s appointments, and she will navigate and support patients as they take their journey through treatment cycles. Intraoperative radiotherapy (using Intrabeam ) allows precise irradiation and reduced postoperative treatment times. 7

8 Mammary Carcinoma diagnostics and therapy Clinical Studies The Breast Center participates in national and international clinical trials to further advance clinical care and treatment for breast cancer, and give their patients access to the latest cutting edge research that has been published on breast cancer and its treatment. This way, our patients are able to benefit from latest therapy approaches and medications. Both clinical trial participation and selection of eligible patients is performed in full compliance with legal regulations and maintaining high ethical standards. Patients which are eligible for a clinical trial are fully informed about all aspects of the clinical trial. Participation in clinical trials is optional. Speak with your Breast Center health care team if you have questions about or interest in any of our current clinical trials. Outpatient and Inpatient Treatment Diagnosis and most of treatments for breast cancer are performed in an outpatient setting. Generally, lumpectomy only is performed on an inpatient basis. For this purpose, you will be admitted to the Department of Gynaecology for inpatient treatment. A compassionate, patient-focused team of doctors, nurses and staff welcome you on the wards, who are exclusively devoted to the treatment of breast cancer and management of breast wound care. A certified breast cancer nurse navigator provides one-on-one support. The hospital discharge package, which you receive before discharge from hospital, contains useful information covering all dimensions on how to proceed the first few days following surgery, and the telephone number of the Breast Center you can call if you have any questions. Support and Survivorship We offer different kind of support for our patients, including psychooncological support. 8

9 Mammary Carcinoma diagnostics and therapy Cancer Risk Assessment and Genetic Evaluation and Counseling During special consultation hours on Breast Evaluation Consultation Program we provide comprehensive counseling to our patients, we discuss and offer genetic testing to evaluate inherited cancer susceptibility, and perform relevant diagnostic tests. For women who do decide to test, and find they have a genetic predisposition to breast cancer, we carefully weigh pros and cons and offer a wide-range of options. Hospital Discharge and Aftercare Following inpatient treatment, it is important that you visit your officebased attending physician on a regular basis for aftercare. A hospital discharge letter will be sent to your attending physician providing detailed clinical information and recommendations. Members of the Social Work Department and the survivorship program at the Klinikum Nürnberg Breast Center is dedicated to providing comprehensive and personalized follow-up care to patients who have undergone breast cancer treatment and arrange for rehabilitation specialized care services, including other outpatient and inpatient treatment services. This includes nursing, social and psychosocial components. They will work with you during your hospital stay to answer questions; help identify any physical, social or emotional needs; and arrange for appropriate services upon discharge. Members of the medical and nursing team at the Breast Center serve a critical role in guiding patients along the continuum of care including aftercare, breast self-examination, lymphatic drainage and massage, physiotherapy, nutrition, sports and exercise programs or psychological support programs. The Breast Care Nurse provides one-on-one support, and facilitates patient care throughout the treatment and recovery processes, and also navigates you through the multispeciality program developed to provide outpatient and inpatient rehabilitation services to all survivors in need, whether you are newly diagnosed or long finished with treatment. 9

10 Cooperation Partners at Klinikum Nuernberg At the breast cancer multidisciplinary clinic, we have multiple specialists in each discipline, so the recommendations for diagnostic evaluation and treatment are based on the consensus opinions of the group of specialists, with consultation from their colleagues in other specialty areas. The breast cancer multidisciplinary clinic is operated under supervision of the Department of Gynecology. Department of Gynaecology Institute of Radiology and Nuclear Medicine, Campus North Department of Radiooncology and Group Practice for Radiotherapy Institute of Pathology Department of Psychosomatic Medicine and Psychotherapy Department of Plastic, Reconstructive and Hand Surgery Department and Institute of Physical and Rehabilitative Medicine and Naturopathy, Early Rehabilitation Department of Anaesthesiology and Operative Intensive Care Social Work Department and Patient Survivorship Program Furthermore, Klinikum Nuernberg cooperates with a series of outpatient partnes in and around the city of Nuernberg. 10

11 Prof. Dr. Cosima Brucker, Dr. Zhorsten Koch and Doktor Simone Linsenbuehler We Care For You! We invite you to visit our Breast Center respectively the Outpatient Treatment Center ABC, Department of Gynaecological Oncology for diagnostic evaluation and therapy, including inpatient treatment at Klinikum Nürnberg, Campus North, to get a second opinion or for high risk assessment and genetic testing. At the Klinikum Nürnberg Breast Center, our team of breast cancer experts specializes in the diagnosis and treatment of breast cancer patients and offers you the most advanced services in breast cancer prevention, diagnosis, and treatment. They will discuss every step of an appropriate course of treatment for you and answer all of your questions regarding breast cancer. When needed, we arrange for support care services. Please contact us, and feel assured you are not alone in this battle. Meet Your Team Of Dedicated Professionals: Prof. Dr. Cosima Brucker, Chief Dr. Thorsten Koch, Director, Breast Center Dr. Simone Linsenbuehler, Coordinator, Breast Center Dr. Frank Gisbert, Specialist in Oncoplastic Surgery Dr. Christine Hoffmann, Breast Surgeon Impressum: Herausgeber: Klinikum Nürnberg, Prof.-Ernst-Nathan-Str. 1, Nürnberg V.i.S.d.P.: Bernd Siegler Redaktion: Doris Strahler Fotos: Rudi Ott, fotolia.com Gestaltung: Jo Meyer Druck: diedruckerei.de 3. Auflage: 1.500, Juli

12 Contact details for patients from abroad International Department of Klinikum Nuernberg Phone: +49 (0) / 7071 Fax: +49 (0) international@klinikum-nuernberg.de 12