University Hospital Berne - Berne, Switzerland

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- Berne, Switzerland General Information New breast cancer cases treated per year 150 Breast multidisciplinarity team members 12 Radiologists, surgeons, pathologists, medical oncologists, radiotherapists and nurses Clinical Director: Barbara Zeyen, MD The Breast and Gynaecological Cancer Unit (Brust- und Tumorzentrum) is part of the University Hospital of Berne (Inselspital). The unit functions in the framework of a large university teaching hospital and is involved in translational and clinical research. It is located in Women's Hospital (Frauenklinik) where the breast, diagnostic imaging and medical oncology units work in close geographic and organizational relationship. The Breast and Gynaecological Cancer Unit has been founded in 2004 as an institution for the interdisciplinary diagnosis and therapy of breast and gynaecological cancers. Since 2011 the gynacologic cancer center is certified by DKG, the breast cancer centre followed with certification in 2012. In addition, the breast cancer centre is certified by the Q-Label of the swiss league against cancer since 2014 and in partnership with the breast centre Solothurn since 2015. University Hospital Berne Friedbühlstr. 19 3010 Berne, Phone: +410316321650 Fax: +410316321567 E-mail: btz@insel.ch Web-site: www.brustzentrum.insel.ch 1/7

CERTIFICATION(S) ACCREDITATION(S) Deutsche Krebsgesellschaft Expiration date: 15 November 2018 This Centre has notified to be certified and, as such, been requested to upload the certification document for further information. When the certification document/s is/are provided, it is/they are made available hereafter. Q-Label Expiration date: 14 June 2018 SGS and Swiss League against cancer This Centre has notified to be certified and, as such, been requested to upload the certification document for further information. When the certification document/s is/are provided, it is/they are made available hereafter. 2/7

Available services Reconstructive/Plastic Surgery Nuclear Medicine Rehabilitation Genetic Counselling Data Management Psycho-oncology Breast Nurses Social Workers Nutritional Counselling Survivorship Groups Sexual Health Counselling Supportive and Palliative Care Integrative Medicine Dedicated Radiologists 2 Mammograms per year 10000 Breast radiographers Screening program Verification for non-palpable breast lesions on specimen Axillary US/US-guided FNAB Available imaging equipment Mammography Ultrasound Magnetic Resonance Imaging (MRI) Available work-up imaging equipment Computer Tomography Ultrasound Magnetic Resonance Imaging (MRI) PET/CT scan Primary technique for localizing non-palpable lesions Hook-wire (or needle localization) Charcoal marking/tattooing ROLL: radio-guided occult lesion localization Available breast tissue sampling equipment Stereotactic Biopsy (Mammography guided) Core Biopsy (Tru-cut) Vacuum assisted biopsy Ultrasound-guided biopsy Fine-needle aspiration biopsy (FNAB, cytology) Core Biopsy Vacuum assisted biopsy MRI-guided biopsy Core Biopsy Vacuum assisted biopsy New operated cases per year (benign and malignant) 167 Dedicated Breast Surgeons 3 Surgeons with more than 50 surgeries per year 2 beds 5 Breast Nurse specialists 2 Outpatient surgery Intra-operative evaluation of sentinel node Reconstruction performed by Breast Surgeons Primary technique for staging the axilla Axillary lymph node dissection Sentinel lymph node biopsy: Blue dye technique Radio-tracer technique Blue dye + Radio-tracer Axillary sampling 3/7

Reconstructive/Plastic Surgery Reconstructive/Plastic surgeons 2 Immediate Reconstruction available Type of breast reconstructive surgery available Remodelling after breast-conserving surgery Reconstruction after mastectomy: Two-stage reconstruction (tissue expander followed by implant) One-stage reconstruction Autogenous tissue flap Latissimus dorsi flap Transverse rectus abdominis (TRAM) Free-flaps (free TRAM, DIEP, SIEA, gluteal, etc.) Surgery on the contralateral breast for symmetry Dedicated Breast Pathologists 2 Available studies Cytology Haematoxylin & eosin section (H&E) Surgical specimen Sentinel node Core biopsy Frozen section (FS) Surgical specimen Sentinel node Immunohistochemistry stain (IHC) Estrogen receptors Progesterone receptors HER-2 Ki-67 Other special studies available Fluorescence in-situ Hybridization for HER-2 gene (FISH) Oncotype Dx (21-gene assay) MammaPrint (70-gene microarray) Prediction Analysis of Microarray 50-gene set (PAM 50) Recurrence score estab. in Bern Parameters included in the final pathology report stage (pt and pn) Tumour size (invasive component in mm) Histologic type Tumor grade ER/PR receptor status HER-2/neu receptor status Peritumoural/Lymphovascular invasion Margin status Dedicated Breast Medical Oncologists 2 Outpatient systemic therapy 4/7

Dedicated Radiation Oncologists Available techniques after breast-conserving surgery (including experimental) Whole-Breast RT (WBRT) Partial breast irradiation (PBI): External beam PBI Interstitial brachytherapy Targeted brachytherapy (MammoSite, SAVI applicator, other devices) Intra-operative RT (IORT) Multidisciplinary Meeting (MDM) / Tumour Board (TB) Regular MDM/TB for case management discussion Twice a week Weekly Every two weeks Other Schedule Cases discussed at MDM/TB Preoperative cases Postoperative cases Specialties/services participating in MDM/TB Reconstructive/Plastic Surgery Genetic Counselling Breast Nurse Service Psycho-oncology Data Manager Further Services and Facilities Nuclear Medicine Lymphoscintigraphy Bone scan Positron Emission Tomography (PET) PET/CT scan Rehabilitation Prosthesis service Physiotherapy Lymph-oedema treatment Breast care nurse counseling Genetic Counselling Specialist Providing Genetic Counselling/Risk assessment service: Dedicated Clinical Geneticist Medical Oncologist Breast Surgeon General Surgeon Gynaecologist Genetic Testing available Surveillance program for high-risk women Data Management Database used for clinical information Data manager available 5/7

Contact details Clinical Director Barbara Zeyen, MD Quality Manager, Internal Medicine, Psychooncology barbara.zeyen@insel.ch +41316321652 Johannes Heverhagen, MD Head of Dpt. johannes.heverhagen@insel.ch +41316322111 Michel Mueller Chairman of Gynecological Oncologymichel.mueller@insel.ch +41316321010 Dpt. Janna Krol, MD Head of Breast Dpt. janna.krol@insel.ch +41316321650 Laura Knabben, MD Staff Surgeon laura.knabben@insel.ch +41316321650 Reconstructive Surgery Mihai Adrian Constantinescu, MD Head of Plastic Surgery Dpt. mihai.constantinescu@insel.ch +41316320292 Doris Babst, MD Plastic Surgeon doris.babst@insel.ch Tilman Rau, MD Head of Gynecologic Dpt. tilman.rau@pathology.unibe.ch Matteo Montani, MD Pathologist matteo.montani@pathology.unibe.ch Mafalda trippel, MD Pathologist mafalda.trippel@pathology.unibe.ch Manuela Rabaglio, MD Medical Oncologist manuela.rabaglio@insel.ch +41316324114 Urban Novak, MD Medical Oncologist urban.novak@insel.ch +41316321650 Kristina Lössl, MD Radiation Oncologist kristina.loessl@insel.ch +41316322111 6/7

How to reach us University Hospital Berne Friedbühlstr. 19 3010 Berne, Phone: +410316321650 Fax: +410316321567 E-mail: btz@insel.ch Web-site: www.brustzentrum.insel.ch From airport: From Zurich (ZRH) or Geneva (GVA) direct trains run every 30 to 60 minutes to Berne. By train: The Swiss rail network SBB has a major hub in Berne so that Berne can be reached easily by train from any Swiss city and from major european cities. By bus or sub-way/underground: At Bern train station take the bus line 11 in 'Inselspital/Holligen' direction. Exit at Inselspital. Last modified: 25 June 2018 7/7