The
"Breast Center"
Concept Comes Of Age
Introduction
On February 1, 1997, a
Health Sciences Foundation Grant from the General Endowment
Fund was awarded to foster the development of the UAB Breast
Center at the Kirklin Clinic. One year later, in February of
1998, the additional 2000 sq ft of space was brought on line
and the expanded services began to be offered. This Center
which is located in the Radiology Department's Mammography
Section at The Kirklin Clinic provides a single identifiable
site from which a team of clinicians skilled in different
specialties provide an entire range of services recognized
as being needed in a modern, full service breast center.
This Center not only increases the utilization of existing
UAB services (such as surgery, rehabilitation sciences, the
Familial Cancer Center and radiation therapy), but also
provides UAB with a high visibility product in an arena of
current national focus. Before the concept of an
all-inclusive Breast Center was developed, there existed a
basic mammography section which was the focus from which the
larger concept emanated.
The Basic Screening and Diagnostic Facility
The aim of this site in the Kirklin Clinic Radiology
Department is to offer in a single identifiable site a
facility and patient care team which provides:
(1) The highest quality screening mammography
(2) Immediate workup and diagnosis of all symptomatic breast
problems which includes the use of diagnostic methods such
as ultrasound, ductography core needle biopsy and fine
needle aspiration cytology.
This means that the patient, regardless of whether she is there for screening, a second opinion, or work-up of a clinical abnormality will receive a report before she leaves the Breast Center. The emotions surrounding this problem of breast cancer are so intense that it is the goal of the UAB Breast Center at the Kirklin Clinic to keep the time of this anxiety to an absolute minimum. It is hoped that the UAB Breast Center will be viewed as an integral part of the overall complete range of Oncology Services offered by UAB, and that it will facilitate a seamless provision of screening, diagnostic and therapeutic choices for the patient presented in an efficient and coordinated fashion across departmental and service lines.
Although there are many activities which occur in the Breast Center, the Interdisciplinary Clinic is unique and represents a true advance in how patients with newly diagnosed breast cancers are handled.
Interdisciplinary Breast Cancer Clinic
In the past, a patient with a newly diagnosed breast cancer faced days of visits to different doctors in different offices and often had questions arise which did not occur to her at the beginning of these visits. This either meant having them go unanswered or going through a complicated telephone effort to get back in touch with one or more physicians.
The Interdisciplinary Breast Cancer Clinic was established for the comprehensive review for newly diagnosed breast cancer cases by a complete team of clinical experts all on the same day. In this Clinic the patient will have her mammographic work-up and pathology slides reviewed, be examined by the members of the interdisciplinary team, and receive the combined opinion of this team as to the treatment options available, all in the same day. This will include a typed report given to the patient immediately.
At every point along the way this team of clinicians provides the highest level of expertise combined with immediate reporting and problem solving. This becomes not just in name, but in function a true team effort.
Following this initial evaluation there are often questions which arise in immediate female family members about their own risk for the development of breast cancer. For these people as well as for any other patients a Risk Assessment Clinic has also been established. This clinic is headed by an extremely experienced oncology nurse, Ms Madeline Harris. In addition to a physical exam and instruction in breast self examination, there will be an assessment of the patient's risk for breast cancer, and when appropriate, referral for genetic testing at the Familial Cancer Evaluation Clinic.
The Breast Center provides rehabilitation services that include before and after surgery exercises, as well as comprehensive lymphedema management by a specially trained physical therapist. A support group, "New Beginning", meets weekly for newly diagnosed breast cancer patients and their families. Breast cancer survivors and "Reach For Recovery" volunteers staff the Interdisciplinary Clinic providing support and serving as mentors to these new ly diagnosed breast cancer patients. The Center also provides post surgical patients with bras and breast forms which help restore their mental and physical well being.
How the Health Sciences Foundation Grant was Pivotal
Following the award of the grant money, many changes could be made both physically and functionally in the existing core of the Breast Center, which was the basic screening and diagnostic facility.
SPACE
A total of almost 2000 square feet of space adjacent to the current mammography section in The Kirklin Clinic became available in two parcels. The latter parcel was acquired on approximately March 11, 1997. Plans were drawn with the collaboration of radiology, hematology-oncology, surgical oncology and Ms Madeline Harris, who now occupies a permanent office in the expanded area. Unexpected delays pushed back the actual construction time, but early in September the renovation began. Construction was complete on December 12, 1997, and furniture began to be delivered the following week.
The additional space houses: a separate mammography film file area, a new work area for transcriptionists and work preparation personnel, a telephone scheduling area housing three carrels, an office for Ms Harris, a large office / meeting area for clinicians, two clinical examination rooms, an expanded stereotactic core biopsy suite with adjacent bathroom and changing room, an enlarged waiting area for mammography patients, and a waiting area just for breast cancer patients and their families.
RENOVATION OF EXISTING SPACE
Moving transcription out of the clinical area has allowed the construction of a new patient waiting area, 4 new dressing rooms, a technologist break area, and an expanded room for the second breast ultrasound unit.
MAMMOGRAPHY FILM FILE AREA
With the case load that currently exists, approximately two hundred master film jackets are transported to and from the Film Annex daily just for mammography. The expansion has allowed the construction of a separate area which will house mammography film jackets on site. The rolling files were installed during the week of December 15, 1997 and will accommodate at least three or four years of mammography studies.
