The Breast Cancer Journey: Together with Primary Care 2016€¦ · Cary Kaufman, MD reast surgery...
18
The Breast Cancer Journey: Together with Primary Care 2016
Transcript of The Breast Cancer Journey: Together with Primary Care 2016€¦ · Cary Kaufman, MD reast surgery...
The Breast Cancer Journey: Together with Primary Care 2016
Morning Discipline Session Speaker Description
7:30 -8:00
Sign-in & Breakfast
8:00 -8:15
WelcomeJennie Crews, MDCary Kaufman, MD
Welcome address and overview.
8:15 -8:45
RadiologyThe Many Pathways of Breast Imaging
Valerie Behrndt, MDPrimary care works with the breast imager to perform the optimal diagnostic regimen from screening to biopsy. Making sense of ever-changing screening guidelines.
8:45 – 9:15 Pathology
Breast Cancer Pathology: A Primary Care Perspective
Greg Wolgamot, MD, PhD
Pathology for breast cancer has transformed from a yes/no diagnosis to providing prognostic factors and directing use of systemic therapies. A discussion focused on the use of current pathology tools from a primary care perspective will be presented.
9:15 – 9:45Nurse Navigation
How Navigation Helps Clear the Obstacle Course of the Breast Cancer Journey
Kimberlee Moses, RNWorking in tandem with primary care providers in our community, breast cancer navigation facilitates the patient's journey. We describe examples of collaboration while maintaining patient and provider's wishes.
9:45 – 10:00 Break
10:00 – 10:30 SurgeryBreast Surgery 2016: When Less is More
Cary Kaufman, MD
Breast surgery has transitioned from extensive procedures to procedures shaped by the degree of disease; from mastectomy to lumpectomy, axillary dissection to sentinel nodes, and surgical excision to ablation without surgery. The current status of local breast cancer care will be discussed.
10:30 - 11:00Breast Reconstruction
The Broad Spectrum of Reconstructive Surgical Options
Tim Whitney, MD
There are many reconstructive options now available to address the varied needs of breast cancer patients. A vision of available and effective procedures will be described to acquaint primary care providers of the various stages of reconstruction to help their patients make decisions.
11:00 – 11:30Primary Care Oncology
What is Primary Care Oncology and the Unique Issues Facing Primary Care Providers
Amy Shaw, MDA new diagnosis of breast cancer complicates our patients’ lives. The primary care provider has a new set of issues to manage while the cancer doctors focus on the tumor.
11:30 – 12:15 Lunch Buffet
Afternoon
Discipline Session Speaker Description
12:15 –12:45
RadiationOncology
Radiation Oncology: Better Targeting Reduces Side Effects
William Hall, MDFine-tuning radiation improves local control while lessening side effects of radiation. There are now a variety of radiation methods that effectively treat the breast cancer patient in 2016.
12:45 –1:15
Medical Oncology
Medical Oncology for the Primary Care Physician
Jennie Crews, MDNewer tests predict those patients who truly need chemo-therapy and those who don't. New targeted therapies now ofer fewer side effects with greater cure rates.
1:15 –1:45
Primary Care Oncology
Focus on Primary Care Oncology: Lessons Learned
Amy Shaw, MDCommon themes have been seen in patients at each stage of treatment. Anticipating those issues may lessen their impact as treatment progresses.
1:45 –2:00
Break
2:00 –2:30
High Risk and Genetics
Cancer Genetic Testing: Utilization of Results for Effective Medical Management Planning
Marianne Lotito, MS, LCGC
The first line of assessment lies with the primary care provider. Assessment of patient and family cancer history to differentiate hereditary vs familial vs sporadic cancer and steps to mitigate risk. New multi-panel testing brings challenges and opportunities for the primary care provider.
2:30 –3:00
Psychological Issues and Support
Individualized Response to the Psychological Issues of Breast Cancer Patients
Leslie Jacobson, MFTPsychological assessment by primary care is vital to patient's emotional health. Patients at any stage of breast cancer may have increased psychological distress. Various patient scenarios and management options will be discussed.
3:00 –3:30
A Look at the Horizon of Breast Cancer CarePanel Discussion
Each discipline anticipates improvements in care in the near and distant future.
Panel: Behrndt, Crews, Hall, Jacobson, Kaufman, Lotito, Moses, Shaw, Whitney, Wolgamot
Our abilities to practice medicine will change in the future. Each discipline will visualize changes in the near and distant future and will describe their expectations.
3:30 -3:45
CME Evaluation wrap-up
Final Words / Evaluation Forms
© Kaufman 2012
Breast Cancer The Most Common Cancer in Women
© Kaufman 2015
Distribution of Breast CancerCDC Data
© Kaufman 2015
Distribution of Screening MammographyYields Late Stage Disease
LEFT FIGURE. Percentage of women aged 50--74 who had recommended breast cancer screening Behavioral Risk Factor Surveillance System, United States, 2008
RIGHT FIGURE. Percentage of breast cancers diagnosed at late stage among women aged ≥50 years - United States,* 2004--2006
Morbidity and Mortality Weekly Report (MMWR)
Found at Centers for Disease Control:
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5909a1.htm
Screening Mammograms Late Stage Disease
© C Kaufman
Distribution of MastectomyRate 2007
-50% lower than average+50% higher than average
Per 1,000 Medicare
© Kaufman 2015Wexelman B, et al. Socioeconomic and Geographic Disparities in Immediate Reconstruction after mastectomy Soc Surg Oncol. Orlando March 2012
Distribution of Reconstruction by State
No Reconstruction Implant Reconstruction
© Kaufman 2015
• There were major gaps in the desired vs. the actual breast care delivered
• Written guidelines were not adequate to impose consistency of breast care
• Designing a quality improvement system should be developed by clinicians
Institute of Medicine 1999, 2013
© Kaufman 2015
Morning Discipline Session Speaker Description
7:30 -8:00
Sign-in & Breakfast
8:00 -8:15
WelcomeJennie Crews, MDCary Kaufman, MD
Welcome address and overview.
8:15 -8:45
RadiologyThe Many Pathways of Breast Imaging
Valerie Behrndt, MDPrimary care works with the breast imager to perform the optimal diagnostic regimen from screening to biopsy. Making sense of ever-changing screening guidelines.
8:45 – 9:15 Pathology
Breast Cancer Pathology: A Primary Care Perspective
Greg Wolgamot, MD, PhD
Pathology for breast cancer has transformed from a yes/no diagnosis to providing prognostic factors and directing use of systemic therapies. A discussion focused on the use of current pathology tools from a primary care perspective will be presented.
9:15 – 9:45Nurse Navigation
How Navigation Helps Clear the Obstacle Course of the Breast Cancer Journey
Kimberlee Moses, RNWorking in tandem with primary care providers in our community, breast cancer navigation facilitates the patient's journey. We describe examples of collaboration while maintaining patient and provider's wishes.
9:45 – 10:00 Break
10:00 – 10:30 SurgeryBreast Surgery 2016: When Less is More
Cary Kaufman, MD
Breast surgery has transitioned from extensive procedures to procedures shaped by the degree of disease; from mastectomy to lumpectomy, axillary dissection to sentinel nodes, and surgical excision to ablation without surgery. The current status of local breast cancer care will be discussed.
10:30 - 11:00Breast Reconstruction
The Broad Spectrum of Reconstructive Surgical Options
Tim Whitney, MD
There are many reconstructive options now available to address the varied needs of breast cancer patients. A vision of available and effective procedures will be described to acquaint primary care providers of the various stages of reconstruction to help their patients make decisions.
11:00 – 11:30Primary Care Oncology
What is Primary Care Oncology and the Unique Issues Facing Primary Care Providers
Amy Shaw, MDA new diagnosis of breast cancer complicates our patients’ lives. The primary care provider has a new set of issues to manage while the cancer doctors focus on the tumor.
11:30 – 12:15 Lunch Buffet
© Kaufman 2015
Afternoon
Discipline Session Speaker Description
12:15 –12:45
RadiationOncology
Radiation Oncology: Better Targeting Reduces Side Effects
William Hall, MDFine-tuning radiation improves local control while lessening side effects of radiation. There are now a variety of radiation methods that effectively treat the breast cancer patient in 2016.
12:45 –1:15
Medical Oncology
Medical Oncology for the Primary Care Physician
Jennie Crews, MDNewer tests predict those patients who truly need chemo-therapy and those who don't. New targeted therapies now ofer fewer side effects with greater cure rates.
1:15 –1:45
Primary Care Oncology
Focus on Primary Care Oncology: Lessons Learned
Amy Shaw, MDCommon themes have been seen in patients at each stage of treatment. Anticipating those issues may lessen their impact as treatment progresses.
1:45 –2:00
Break
2:00 –2:30
High Risk and Genetics
Cancer Genetic Testing: Utilization of Results for Effective Medical Management Planning
Marianne Lotito, MS, LCGC
The first line of assessment lies with the primary care provider. Assessment of patient and family cancer history to differentiate hereditary vs familial vs sporadic cancer and steps to mitigate risk. New multi-panel testing brings challenges and opportunities for the primary care provider.
2:30 –3:00
Psychological Issues and Support
Individualized Response to the Psychological Issues of Breast Cancer Patients
Leslie Jacobson, MFTPsychological assessment by primary care is vital to patient's emotional health. Patients at any stage of breast cancer may have increased psychological distress. Various patient scenarios and management options will be discussed.
3:00 –3:30
A Look at the Horizon of Breast Cancer CarePanel Discussion
Each discipline anticipates improvements in care in the near and distant future.
Panel: Behrndt, Crews, Hall, Jacobson, Kaufman, Lotito, Moses, Shaw, Whitney, Wolgamot
Our abilities to practice medicine will change in the future. Each discipline will visualize changes in the near and distant future and will describe their expectations.
3:30 -3:45
CME Evaluation wrap-up
Final Words / Evaluation Forms
© Kaufman 2015
© Kaufman 2015
© Kaufman 2015
Each Speaker:
Please Introduce Yourself to the Audiencewith the Following Information . . .
• Where did you train? (medical school, residency, etc.)
• How long have you been “here” (Bellingham or Elsewhere)
• What most interests YOU (or gives you satisfaction) about
breast care?
© Kaufman 2016
Over Pinked?
Over-pinked?
Increasing Awareness
Over Pinked?
Increasing Awareness
