Surviving the Summer Heat Information for ... - LMU Klinikum
Breast Center - klinikum-nuernberg.de · 2018-09-11 · cosmetic appearance. Almost 90 percent of...
Transcript of Breast Center - klinikum-nuernberg.de · 2018-09-11 · cosmetic appearance. Almost 90 percent of...
1 www.klinikum-nuernberg.de/RU --- [email protected]
Breast Center
Gynecology Department Paracelsus Medical University
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
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 2006. 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 quality-management 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]).
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
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
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 vacuum-
assisted breast biopsy.
The breast cancer staging workup and TNM classification is performed
complying with international standards in close cooperation with our in-
house 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:
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.
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.
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 office-
based 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.
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 out-
patient partnes in and around the city of Nuernberg.
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, 90419 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 2018 | www.klinikum-nuernberg.de
12
Contact details for patients from abroad
International Department of
Klinikum Nuernberg
Phone: +49 (0)911 398 7082 / 7071 Fax: +49 (0)911 398 7441
[email protected] www.klinikum-nuernberg.de/EN