Universitätsfrauenklinik Ulm - Interdisziplinäres Brustzentrum - Ulm, Germany

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- Ulm, Germany General Information New breast cancer cases treated per year 380 Breast multidisciplinarity team members 14 Radiologists, surgeons, pathologists, medical oncologists, radiotherapists and nurses Clinical Director: Rolf Kreienberg, MD The University Hospital of Gynaecology and Obstetrics of Ulm University has a Breast Unit with EUSOMA accreditation and certification of excellence by the German Cancer Society and is part of the multi-disciplinary Comprehensive Care Center of the University of Ulm (CCCU). The Breast Center Unit cares for around 350 women per year with primary breast cancer. We have specially trained staff caring for breast patients. The unit provides care for all stages of breast disease. We provide outpatient counseling, special counseling for families with high tumor risk and follow up counseling. All diagnostic and interventional radiological measures are offered (LCNB, stereotactic vacuumbiopsy). The Breast Unit is a reference center for the population-screening program of southern Germany. All counseling cases are discussed in our weekly multi-disciplinary board consisting of gynaecologal surgeons, radiologists, pathologists, radiotherapists and gynaecological and internal oncologists who decide the management plan of surgery (includine reconstructive oncoplastic surgery) and post-surgery systemic treatment. Universitaetsfrauenklinik Ulm - Interdisziplinares Brustzentrum Prittwitzstrasse, 43 89075 Ulm, Germany Phone: +4973150058501 Fax: +4973150058502 E-mail: rolf.kreienberg@uniklinik-ulm.de Web-site: www.uniklinik-ulm.de/ufk 1/6

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 3 Mammograms per year 2600 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) 379 Dedicated Breast Surgeons 4 Surgeons with more than 50 surgeries per year 3 beds 11 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 2/6

Reconstructive/Plastic Surgery Reconstructive/Plastic surgeons 1 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) 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 3/6

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 Further Services and Facilities Nuclear Medicine Lymphoscintigraphy Bone scan Positron Emission Tomography (PET) PET/CT scan Rehabilitation Prosthesis service Physiotherapy Lymph-oedema treatment 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 4/6

Contact details Clinical Director Rolf Kreienberg, MD Head of the Breast Unit - Former President of the German Society of Gynaecology and Obstetrics rolf.kreienberg@uniklinik-ulm.de +4973150058500 Stefan Puig, MD Senior Attending Radiologist stefan.puig@uniklinik-ulm.de +4973150061045 Susanne Duerr, MD Attending Radiologist susanne.duerr@uniklinik-ulm.de +4973150061251 Georg Sauer, MD Acting Manager of the Breast Unit georg.sauer@uniklinik-ulm.de +4973150058553 Martin Bäuerle, MD Senior Assistant of the Breast Unit martin.baeuerle@uniklinik-ulm.de +4973150058561 Rolf Kreienberg, MD Head of the Breast Unit, Medical Director rolf.kreienberg@uniklinik-ulm.de +4973150058500 Christopher Wolf, MD Consultant drchristopherwolf@arcor.de +497319201621 Reconstructive Surgery Rolf Kreienberg, MD Head of the Breast Unit rolf.kreienberg@uniklinik-ulm.de +4973150058500 Georg Sauer, MD Acting Manager of the Breast Unit georg.sauer@uniklini-ulm.de +4973150058553 Axel-Mario Feller, MD Plastic Surgeon a.m.feller@professor-feller.de +49892111300 Karin Koretz, MD Senior Pathologist karin.koretz@uniklinik-ulm.de +4973150058820 Frank Leithaeuser, MD Pathologist frank.leithaeuser@uniklinik-ulm.de +4973150056344 Regine Mayer-Steinacker, MD Senior Medical Oncologist regine.mayer-steinacker@uniklinik-ulm.de +4973150045534 Andreas Viardot, MD Senior Medical Oncologist andreas.viardot@uniklinik-ulm.de +4973150045539 Thomas Wiegel, MD Head of Dpt. thomas.wiegel@uniklinik-ulm.de +4973150056100 5/6

How to reach us Universitaetsfrauenklinik Ulm - Interdisziplinares Brustzentrum Prittwitzstrasse, 43 89075 Ulm, Germany Phone: +4973150058501 Fax: +4973150058502 E-mail: rolf.kreienberg@uniklinik-ulm.de Web-site: www.uniklinik-ulm.de/ufk From airport: Stuttgart Airport - 1h. by car to the Breast Unit. Munich Airport - 1.5h. by car to the Breast Unit. By train: From Ulm train station it takes 10 min. by bus or 5 min. by taxi or a 30 min. on foot to our Breast Unit. By bus or sub-way/underground: Take the local bus No 7 to the bus station 'Kliniken Michelsberg' - then it takes a 3-min walk to the main entrance of Women's hospital and Breast Unit. By car: Follow the signs 'Unikliniken Michelsberg' and use the car-park at the campus. Then follow the signed way to the 'Frauenklinik'. Last modified: 17 December 2010 6/6