Breast Care Center: One year later…
She eats right, gets plenty of exercise, and thinks good thoughts. She looks after family, cares about close friends, and donates generously to causes like breast cancer, AIDS, and violence against women. She knows how to save an orchid, cook pasta al dente, and dance so her partner looks smooth. She laughs with her whole body, gives hugs with her eyes, and keeps secrets and promises forever.
Last fall, she was diagnosed with breast cancer and everything stopped. Until her friends and family talked her into paying a visit to Community Hospital’s Breast Care Center in Monterey.
“It wasn’t the first place I went,” says Denise Engelke, 56, “but it was totally different than the other place. As soon as I got there, I felt safe. I wasn’t just another person coming in with the same problem; they cared about me personally. I was the only case that mattered in that moment. For the first time, I didn’t feel doomed.”
One year ago, Dr. Pamela Craig approached the opening of the new comprehensive Breast Care Center with the intent that “it can actually be a positive experience, especially if the woman has the chance to tap into her strength.
“Consider Lance Armstrong and what he has overcome and gone on to achieve. I wouldn’t wish his experience on anyone, but he says it’s the best thing that has happened in his life. That is my goal in this community,” Craig explained at the time. One year later, Craig and her team are living their goal, one day at a time.
“I think what we’ve done,” says Craig, “is provide a wonderful place for patients to come, both to have their screening mammograms and then to have their work-ups. The second thing we’ve done is eliminate surgical biopsies for diagnoses; we’re able to do this with needle biopsies and do it without surgery. If we know ahead of time that a woman has cancer, we can talk with her about her options. This year, 92 percent of our patients with initial findings that required a biopsy had preoperative needle biopsies and had a diagnosis before any surgery was done.”
The third thing they’ve done is provide a place for women to get second opinions and additional information, a place where women feel comfortable, safe, and resourceful.
“At the Breast Care Center,” says Engelke, “they gave me all kinds of options and tried to give me enough information to help me feel like it was my decision, not just theirs. It was empowering. I felt better about the whole situation. The door wasn’t shut; I saw a light at the end of the tunnel. Suddenly, I wasn’t afraid.”
Women with a cancer diagnosis are able to consult with clinicians in advance of their surgery, which means they can explore treatment options and recommendations to become more active participants in choosing the level and type of care they receive.
“We have seen 11,534 women and performed 22,915 procedures through December 2002,” says Dr. Susan Roux, director of breast imaging and diagnosis. “We have found 133 cancers in 131 patients — two patients had a cancer in each breast. The number of women diagnosed with small cancers seen on screening mammography was 63, and only 18 percent had positive lymph nodes.” This is significantly better than the national benchmark of 25-percent positive nodes. Cancer is being caught before it spreads beyond the breast itself.
In 2001, many Peninsula women diagnosed with cancer made two trips to the operating room, the first to make the diagnosis and the second to receive treatment. In 2002, most made only one trip.
“Probably 80 percent to 85 percent of all of our cancer patients require only one surgery,” says Roux, “because they were diagnosed with a needle biopsy. Then, when the surgeons know that they’re operating on a cancer, they take extra tissue around it to get good margins. We’re also able to do lymph-node biopsies the very same day we take the cancer out. I think two operations can be traumatic for a woman. We’re streamlining the process.” 