2011 Fairview Ridges Hospital Oncology Annual Report
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1 2011 Fairview Ridges Hospital Oncology Annual Report Fairview Ridges Hospital would like to thank the members of the Cancer Committee for their hard work and dedication to improving the screening, treatment and diagnosis of patients with cancer In particular, the Cancer Committee would like to thank Dr. Philip Dien M. D. for his many years of leadership of the Cancer Committee. Dr. Dien was the primary driving force in the development of an oncology service for the Fairview Ridges Hospital. As the oncology service grew, Dr.Dien was instrumental in the formation of the Cancer Committee and subsequent accreditation at Fairview Ridges Hospital by the Commission on Cancer. Chair, Philip Dien, M.D. Peter Conklin, M.D. Matthew Gall, M.D., M.S. Avina Singh, M.D. Nancy Guttormson, M.D. Timothy Kappel, M.D. Kimberly McCollow, D.O. Troy Scott, M.D. Kari Hurley, R.N. Ryan Poppinga, PharmD. Meghan Campbell, CTR Beth Bouman L.S.W. Linda Reuber R.N. Kate Cummings, R.N. Elisa Ricciardi, R.N. Brian Knapp Hospital Administrator Tonya Larson, R.N. The Fairview Ridges Hospital Cancer Committee is pleased to present our 2011 Annual Report. This year s report focuses on the management of breast cancer and features the services we have been able to offer our breast cancer patients. The report reviews and analyzes our Tumor Registry data on breast cancer, the most common cancer diagnosis at Fairview Ridges Hospital. The Cancer Program is accredited by the American College of Surgeons Commission on Cancer and we are proud to maintain its high standards of accreditation. At Fairview Ridges Hospital, we focus on delivering exceptional cancer care through state-of-the-art clinical trials, utilizing national treatment guidelines, organizing educational conferences for physicians and staff members and continually improving and monitoring our quality of care. 1
2 Fairview Ridges Hospital Breast Cancer Care Breast cancer represents the most common cancer diagnosed at Fairview Ridges Hospital. It accounted for percent of all of the new cancer cases diagnosed at the hospital in Mammography is critical to the early detection of breast cancer in order to achieve better outcomes. In 2010, around 10,756 screening mammograms done at the Fairview Ridges Women s Imaging Center. The goal of the Fairview Ridges Hospital Cancer Program and Fairview Ridges Women s Imaging Center is to provide a seamless, timely and successful experience for patients who are screened and treated for breast cancer. It is through the collaboration of our skilled physician specialists and utilization of the resources at the Fairview Ridges that our patients receive effective cancer care. Our breast cancer team meets monthly to review patient cases, collaborate on treatment plans, share perspectives on current research and ensure compliance with national treatment guidelines. This multi-disciplinary team discusses individual patients who present unique situations that can benefit from the team s opinions. The treating physician can take this information from our experts and discuss it with the patient to finalize a treatment plan. Patients appreciate this type of enriched consultation and discussion. We are proud to present a team of care providers whose collaborative efforts ensure that Fairview patients receive the most up-to-date care in the diagnosis and treatment of breast cancer. Radiologists: Peter Conklin, MD; Mary Foshager, MD; Steven Thiel, MD Pathologists: Manual Guzman-Paz, MD; Timothy Kappel, MD; John Wogensen, MD General Surgeons: Douglas Bailey, MD; Elizabeth Gavin, MD; Nancy Guttormson, MD; Ron Jenson, MD; David Mauer, MD, Ryan Odonell, MD. Dr. Lizbeth Thomas, D.O. Plastic Surgeon: Jacqueline Luong, MD Medical Oncologists: Philip Dien, MD; Matthew Gall, MD; Avina Singh, MD; Eric Weinshel, MD Radiation Oncologist: Kimberly McCollow, DO Breast Center Navigator: Tonya Larson, RN, OCN 2
3 Patients Benefit from Advanced Digital Technology Patients undergo screening for breast cancer based on their age, history and risk factors. Once their primary care physician orders a mammogram, patients have access to our fully digital Fairview Ridges Women s Imaging Center. The capabilities at Fairview Ridges Women s Imaging Center exceed what is being offered in other locations. Being fully digital means our center can provide: Digital screening mammograms Diagnostic digital mammograms and ultrasound Ultrasound guided core needle biopsy Breast needle wire localization under mammography or ultrasound Breast MRI Onsite radiologist Nurse navigator Stereotactic biopsy When an abnormality is found and a biopsy is required, the above services are utilized to their fullest capacity. The Nurse Navigator provides support for follow-up procedures, education, and ensures results are reported to the patients with- in two days. This rapid notification is a priority. Once a positive biopsy is found the team s priority to have the patient receive the necessary consultations to begin a treatment plan within 2 weeks. This patient is supported through this process by the Nurse Navigator. The patient is considered for any or all of the following treatments. Initial surgery with sentinel node injection Options for reconstruction with Dr. Luong Radiation therapy using new linear accelerator with capabilities for imaged guided treatment and Intensity-modulated therapy at Ridges Radiation Center. Chemotherapy, hormone and targeted therapies under the direction of Minnesota Oncology physicians 3
4 Fairview Ridges Hospital Breast Cancer Summary Breast cancer accounted for 127 of the 401 new cancer cases at Fairview Ridges Hospital in 2010, and is the most common cancer site diagnosed and treated at this hospital. 1. Graph of cancer by site 2. Graph of breast cancer by stage( did not see any meaningful trend) INITIAL TREATMENT OF BREAST CANCER BY STAGE IN 2010 AJCC STAGE 0 I II III IV No Treatment Surgery Surgery/Chemo Surgery/Chemo/Hormone Surgery/Hormone Surgery/Radiation/Chemo/Hormone Surgery/Radiation/Hormone Surgery Hormone Palliative Total
5 3. Graph of breast cancer by age 4. Graph of treatment modalities by stage or in tabular form INITIAL TREATMENT OF BREAST CANCER BY STAGE IN 2010 AJCC STAGE 0 I II III IV No Treatment Surgery Surgery/Chemo Surgery/Chemo/Hormone Surgery/Hormone Surgery/Radiation/Chemo/Hormone Surgery/Radiation/Hormone Surgery Hormone Palliative Total
6 5. Survival curves comparison with national data base Observed Survival by Best AJCC Stage Report Fairview Ridges Hospital vs NCDB Interval (years) Stage 0 FRH (n= 30) 100.0% 100.0% 100.0% 100.0% 100.0% NCDB (n= 24,816) 99.4% 98.6% 97.6% 96.7% 95.4% 6
7 Interval (years) Stage I FRH (n=65) 98.5% 98.5% 98.5% 98.5% 94.8% NCDB (n= 50,645) 99.0% 97.7% 96.0% 94.0% 91.8% Interval (years) Stage II FRH (n=53) 98.1% 98.1% 98.1% 98.1% 93.6% NCDB (n= 36,758) 98.1% 94.8% 91.3% 88.0% 84.8% 7
8 Interval (years) Stage III FRH (n=19) 94.7% 94.7% 89.5% 89.5% 89.5% NCDB (n= 13,831) 94.0% 84.9% 76.9% 70.4% 64.5% Stage IV Interval (years) FRH (n= 4) 100.0% 75.0% 50.0% 25.0% 0.0% NCDB (n= 4,661) 63.5% 46.7% 35.5% 27.3% 20.8% 8
9 Trends and Accomplishments Breast cancer remains the most common cancer diagnosed and treated at Fairview Ridges Hospital. The trends and accomplishments for 2010 are: The Fairview Ridges Women s Imaging Center and improved technology has increased the hospital s capacity to perform timely screening and diagnostic mammograms and biopsies. Increased use of Oncotype dx, for making treatment decisions for chemotherapy and endocrine therapy ( in keeping with ASCO and NCCN guidelines) New and expanded Breast Center- with access to full diagnostic imaging. Future plans include opening of a high risk clinic with on-site genetic counselor Education provided by a nurse navigator and multidisciplinary cancer care conference has had a positive impact on patients. Survival comparison was done to NCDB and the 5 year survival by stage appears to be a bit higher in our database.(graphs attached) 9
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