In the United States, breast cancer is the second most common cancer in women after skin cancer, and though rare, it can also occur in men. Following recommendations for routine screenings can help detect breast cancer early. At New Hanover Regional Medical Center, the team at Zimmer Cancer Center offers a multidisciplinary clinic for breast cancer patients.
“Being an accredited cancer center, having a multidisciplinary clinic is really the highest standard of care, and the fact we have it in a community of this size is exceptional,” said Laura C. Clark, RN, a Nurse Navigator/Program Coordinator at NHRMC and a Certified Breast Cancer Navigator.
Importance of screenings
Mammography is the most widely used screening tool for breast cancer detection. Many breast cancers can be detected on screening mammograms, and often at an earlier stage, before they can be felt and before symptoms appear.
For those who cannot afford mammograms, community resources, such as The Pink Ribbon Project, provide access to screening mammograms.
If findings from the mammogram indicate a potential problem, a biopsy will likely be recommended. If the biopsy confirms cancer or a high-risk lesion, some patients will be referred directly to an oncologist, and others will be referred to the multidisciplinary breast clinic.
Approach to care
At the breast clinic, a team of health professionals work together to deliver comprehensive patient care. Each Monday morning, a breast cancer conference is held where surgical oncologists, medical oncologists, radiation oncologists and other medical professionals gather to review new cases and discuss the most appropriate course of treatment for each patient, who will be seen at the clinic that day.
The team reviews medical records, radiographic imaging such as mammograms/MRIs and ultrasounds and pathology reports to form a custom treatment plan for each patient.
Another key benefit of the breast clinic is that it gives patients the opportunity to access multiple services on their first visit. For example, patients may meet their medical oncologist and radiation oncologist on the same day, which can help reduce the time between diagnosis and treatment. In that visit they may also have bloodwork and genetic testing, receive assistance with coordinating services and setting appointments and have access to other health professionals who will aid in their care.
The care team also includes nurse practitioners/physician assistants, genetic counselors, pharmacists, physical therapists, oncology dietitians, social workers and financial counselors who work together to meet patients’ needs.
Role of nurse navigators
A key part of the breast program is access to Clark, a Certified Breast Cancer Navigator, who helps patients through their breast cancer treatment and helps patients gain access to resources.
Being diagnosed with cancer can cause anxiety, uncertainty and lead to various challenges, but a nurse navigator provides direction, support and encouragement to help patients develop a course of action. They help patients and families from initial diagnosis through treatment and beyond.
“The navigator is basically the liaison to the community and the liaison between the clinical staff and patient, and we work to make sure that the physical, emotional, and spiritual needs are addressed for the patient,” said Clark.
“I like the fact that our physicians look at patients beyond the cancer they have,” she said. “They realize there are other needs that will arise that are not medical, like mental health needs, or a need for transportation. There are patients who have lost their jobs and have a need for financial assistance.”
The breast cancer navigator can help patients understand their diagnosis, explain treatment options, coordinate appointments, provide emotional support, and connect patients to resources for transportation, medication and spiritual needs and other services such as nutritional counseling, physical therapy, clinical trials, genetic testing, financial assistance and home healthcare.
How to reduce your risk
Various factors can increase one’s risk for breast cancer. Clark said while there are some risk factors that are outside of one’s control, such as race, age, gender, family history and genetics, one can still do what you can to reduce your risk.
“We can control our awareness of our health,” Clark said. “You can do things to mitigate your risk, such as exercising, staying within a normal weight, eating healthy, and reducing the number of alcoholic beverages you have in a week.”
Clark also encourages doing breast self-exams and getting mammograms.
“Screening is important, but it’s also about knowing your risk factors and being aware of any changes in your breast,” she said. “A lot of people don’t want to do self breast exams, but recognizing changes is important.”
Some warning signs of breast cancer include:
• A new lump in the breast or underarm (armpit)
• Thickening or swelling of part of the breast
• Irritation or dimpling of breast skin
• Redness or flaky skin in the nipple area or the breast
• Pulling in of the nipple or pain in the nipple area
• Nipple discharge other than breast milk, including blood
• Any change in the size or the shape of the breast
• Pain in any area of the breast.
These symptoms can happen with other non-cancerous conditions, but you should notify your medical provider if any of these symptoms occur.
For more information, visit www.nhrmc.org/cancer.