Pique Your Interest: NCoBC2014 Conference Course Synopses

New Insights for the Diagnosis of Benign Breast Disease

Tuesday, March 18 at 2:10pm during the Clinical Track Breakout

Extreme Oncoplasty

Tuesday, March 18 – 8:00-8:30am as part of plenary [in place of previously scheduled "DCIS – The Dilemma Continues]

Melvin J. Silverstein, MD, FACS
Director, Breast Program, Hoag Memorial Hospital Presbyterian
Clinical Professor of Surgery, Keck School of Medicine
University of Southern California

Oncoplastic breast conservation combines oncologic surgery with plastic surgical principles. While standard oncologic resection often results in a deformed breast, oncoplastic resection attempts to widely excise the cancer while achieving a good or excellent cosmetic result. This type of surgery is generally used in patients with tumors 5 cm in extent or smaller. Patients with larger tumors often require mastectomy.

What happens when a patient with a large tumor, great than 5 cm, wants breast preservation? What if the tumor is multifocal or multicentric, can oncoplastic breast preserving surgery still be used? What if a patient needs a mastectomy but refuses?

This talk will present a series of patients, all of whom were correctly counseled to have a mastectomy. All of whom refused. Most of the tumors were multifocal or multicentric and between 5 -10 cm in extent. Some of the tumors were in relatively small breasts. Oncoplastic surgery was pushed to the extreme and all of the cases were successfully excised using state-of-the art oncoplastic resections.

Data will be shown comparing more than 60 extreme oncoplastic cases with more that 200 standard oncoplastic reduction excisions.

Update on Accelerated Partial Breast Irradiation

Tuesday March 18 at 10:30am

Reshma Jagsi, MD
Associate Professor, Department of Radiation Oncology University of Michigan

Adjuvant radiation therapy has traditionally been administered to the whole breast over five to six weeks. However, concerns have arisen regarding the convenience, access, and cost of this approach. If radiation is administered to only part of the breast, relatively large doses per fraction may be tolerable and allow for substantial acceleration of treatment. Therefore, inspired by findings that suggest that the majority of local recurrences after breast-conserving surgery occur in the region of the tumor bed, investigators have been motivated to explore accelerated partial breast irradiation (APBI). Many techniques of administering APBI exist.

In this session, the speaker will review the rationale for APBI, the variety of techniques that are under investigation, and the evolving evidence regarding patient selection, efficacy, and toxicity in this setting.

This session will discuss the variety of different techniques available for delivery of APBI, describe patient and pathologic features that may guide appropriate case selection, and review evolving evidence regarding the efficacy and toxicity of various APBI approaches.

Conducting a Breast Health Needs Assessment – Where to Begin?

Saturday March 15 - 8:15 – 8:45am in the Navigation Pre-session

Jeremy Patch, MPH
Community Health Analyst
Susan G. Komen

A community needs assessment can be a critical tool for program planning, including navigation programs. Needs assessments help an organization understand the people it serves and how they access and progress through the healthcare system, including bringing to light barriers to accessing care.

Topics discussed will include how to

  • begin a breast health needs assessment
  • identify key stakeholders and critical resources
  • budget appropriately to assure sound funding
  • gain support from administration
  • use the assessment for program planning purposes

Think Globally, Act Locally — Reducing Costs in Breast Imaging

Wednesday, March 19th at 2:00-2:30pm in the plenary session

Gerald Kolb, JD
Chief Executive Officer, Ikonopedia, Inc.
Dallas, TX

The Affordable Care Act — Obamacare — is a fact-of-life for healthcare providers that will drive change across the industry. As with most change that occurs in human endeavor, there will be winners and there will be losers, both individually and organizationally, as we move through the process of change. In this session, the presenter will develop a clear understanding of the basics of healthcare economics and attendees will take away the basics necessary to immediately begin reducing costs in breast imaging — while providing higher quality care.

Does "spa-like environment" refer to granite countertops or workflow? Do you use "airplane" scheduling? Do you proactively schedule? Do you think of measurement or information when you hear the term metric? Do you understand any of the foregoing? If what you have just read is at all puzzling, you need to attend this session, as the questions all refer to cost saving concepts in breast imaging while maximizing patient, physician and staff satisfaction.

Participants in this session will, quite literally, learn techniques that they can implement upon return to their breast centers — or at the very least, begin the conversations that will quickly lead to improvements. Of equal importance, each attendee will leave the session looking at all of the tasks in a breast center in a different manner.

Breast Cancer Issues for Young Breast Cancer Survivors Less Than 35

Tuesday, March 18 at 11:30am during plenary session

Anne Katz, PhD, RN
Sexuality Counselor, /cancer Care Manitoba
Winnipeg, MD, Canada

Young women with breast cancer face unique challenges along the disease trajectory. Questions about the following issues are commonly asked by this population.

  • future fertility
  • interventions to protect childbearing potential
  • disclosure of cancer status to potential partners
  • dating
  • becoming sexual with a new partner
  • body image

This presentation will highlight what these women face with suggestions for health care providers to assist them in finding solutions.

Survivors Without Survivorship Care Plans: What You Can Do To Help Now

Wednesday March 19 at 1:30pm

Rochelle L. Shoretz, Esq
Founder and Executive Director Sharsheret: Your Jewish Community Facing Breast Cancer

Survivorship care plans play a critical role in a breast cancer survivor's journey. However, many survivors complete treatment without a care plan and face challenges in crafting a one once treatment has ended – including finding an appropriate care plan and gathering medical history.

Health care professionals are in a unique position to assist and support patients in this process.

This session will offer an "after the fact" model with which Sharsheret, a national not-for-profit organization supporting young women facing breast cancer, has been successful in helping women work with health care professionals to craft a care plan long after the completion of treatment.

Strategies offered will enable health care professionals to support patients as they create individual care plans and seek survivorship resources. The strategies will include identification of appropriate care plans and survivorship resources, assistance in information gathering, and discussion of the vital role of a care plan.

Dense Breast Tissue Density Laws — Just the Facts, Ma'am: The Technologist's Role in Breast Density Education

Monday, 10:30am in RT Track

Gerald Kolb, JD
Chief Executive Officer, Ikonopedia, Inc.
Dallas, TX

Breast density notification laws are now on the books in sixteen states, are in the national legislative process in Washington DC, and notification regulations are currently being considered as a part of the MQSA. Density is a radiologic feature that affects both causal risk for breast cancer and the sensitivity of the mammogram and, while there has been a great deal of discussion about the legislation and how to apply density findings to patient care, the role of the technologist has received little discussion.

The biggest challenge in density notification is the general lack of information about the implications of dense tissue on the part of both patients and the referring physician community. This has led to a secondary issue of large volumes of calls from uncertain patients to their primary care physicians and the uncompensated time that this imposes on already pressed physicians.

In this session, the basics of breast density will be discussed, and the presenter will suggest several important roles for the technologist who have come about because of density notification legislation. Needless to say, the role of the technologist continues to evolve