MDNews - San Antonio

Methodist Hospital to serve patients from the downtown area. This conference is facilitated by Kathy Grove, MD, Medical Director of the Metropolitan Methodist Hospital Breast Center. Diagnostic Expertise The team approach begins with women receiving screening mammograms at one of 12 South Texas Radiology Imaging Center facilities, conveniently located across the region. Specialty-trained radiologists perform state-of-the-art ultrasound and stereotactic breast biopsies. Tissue samples that are sent to a Methodist facility are carefully scrutinized by expert pathologists who have extensive training in interpreting breast cancer cases. "Close to 1,000 newly diagnosed women with breast cancer had their pathology reviewed at a Methodist facility," Tinker says. "With that volume of experience, women can have comfort that the correct diagnosis is called the first time." Collaborative Excellence Lines of communication don't stop at the conclusion of breast conferences. Dr. Larson notes that a strong sense of collaboration and open phone lines between pathologists, radiologists and oncologists promote correct diagnoses and effective care, even for the most complex cancer types. At least two pathologists examine each biopsy core to corroborate radiologists' or clinicians' findings. Because the pathology group features fellowship-trained breast pathologists and only hires physicians with fellowship or specialty training in areas of expertise complementing the needs of patients receiving care at Methodist facilities, one set of eyes would account for expert precision, but the added safeguard bolsters diagnostic certainty. In the same manner, pathologists often visit the radiology department to examine radiographic images of patients with excisions to ensure that all areas of interest are sampled and identified, and their relationships to margins are considered. This close working relationship facilitates fast turnaround times for diagnoses, which Dr. Larson explains is a key consideration for patients. "We want to get the correct diagnosis right away because we know, following a biopsy, there's a patient sitting at home beside herself wanting to know what's going on," Dr. Larson says. "So we try very hard to provide 24-hour turnaround service for most breast core biopsies. If I get a core to read on Friday, I do my very best to get that report out so the patient isn't sitting at home over the weekend worrying about it." S t e v e n P isa no, M D, Co-Founder of PRMA Surgery, has served on faculties of and received training from top national facilities, including University Steven Pisano, MD of Texas MD Anderson Cancer Center, and doesn't shy away from praising the pathologists at Methodist Healthcare. "Methodist Healthcare System has resources that include some of the finest pathologists in the country, and it doesn't stop there," Dr. Pisano says. "Along with pathologists, there are surgeons and oncologists on the leading edge in coming to the right diagnosis and performing surgery, ensuring we get the cancer out and all margins are clear. That's where the rubber meets the road." From Dr. Pisano's perspective, the pathology team distinguishes itself by identifying every nuance — which can include multiple lesions, margins too close to the skin or too unclear, and the need to surgically remove more tissue — in each case he sees. The Methodist Difference Following diagnosis and presentation of the case at a breast tumor conference, the treatment team takes action to fight breast cancer. Brittany DeBerry, MD, partner with General Surgical Associates and Surgical Chair at Methodist Hospital explains, "There is no cookie-cutter solution for dealing with breast cancer. Every C U RI N G LY M PH ED EMA? WOMEN WHO HAVE lymph nodes removed from under their arms during surgical procedures for breast cancer are at risk for lymphedema, which causes swelling in the arm, breast and chest due to reduced lymphatic fluid drainage. Traditional treatments — such as elevating the affected limb and using compression sleeves, wraps or massages — can reduce the swelling for a short period of time, but patients will have to repeat the process continually, according to Steven Pisano, MD, Co-Founder of PRMA Breast Reconstructive Surgery. Dr. Pisano provides an innovative surgical procedure only at Methodist Hospital that can completely cure lymphedema. Vascularized lymph node transfer involves transplanting as many as seven lymph nodes with their own blood supplies from another part of the body, typically the groin or the inguinal lymph nodes, to the underarm area. Surgeons reconnect the blood vessels for circulation, and the new set of lymph nodes assimilate to their surroundings and drain excessive lymphatic fluid just as the originals would. Though the procedure is new, Dr. Pisano says the results can restore quality of life. "For many women, lymphedema significantly impairs their lifestyles and abilities to work because the swollen arm is heavy, aching and limiting their range of motion," Dr. Pisano notes. "Vascularized lymph node transfer can completely cure lymphedema, or at least reduce the condition to manageable proportions." MDNEWS.COM I MD NEWS San Antonio |7

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