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Navigating breast cancer care: UTMB's comprehensive approach

Nov 3, 2023, 12:15 PM by Holly Galvan Posey with Community Impact's Storytelling team

At UTMB Health, breast cancer patients find not just treatment but a comprehensive care experience. Patients can connect with their surgeon, medical oncologist, radiation oncologist and plastic surgeon all in one convenient location, often within a single day.

From prevention through survivorship support, UTMB offers powerful tools like 3D mammography for early detection and modern therapies to combat the impact of breast cancer

The front line for breast cancer care

Dr. Sarah Bruce, a UTMB Health OB-GYN, highlighted UTMB’s shift toward promoting breast self-awareness in alignment with the recommendations of the American College of Obstetricians and Gynceologists (ACOG).

“The big difference is each patient is encouraged to recognize changes with their breasts and [notify] their providers. UTMB's patient access services make it easy and seamless to schedule an appointment with a gynecologist for breast-related concerns, and patients are able to be seen in a timely manner” Dr. Bruce said. “Referral to OB-GYN for a clinical exam is one of the first steps to evaluating breast-related concerns.”

Treatment and cancer screening techniques continue to evolve, Dr. Bruce said, and UTMB remains on the cutting edge.

“UTMB adheres to the most up-to-date guidelines when it comes to breast cancer screening. Specifically, we believe in risk stratification that individualizes screening protocol based on lifetime risk of breast cancer,” Dr. Bruce said. “For low- to average-risk patients, we recommend annual screening mammograms starting at age 40. For high-risk patients, we recommend screening every six months, alternating between mammogram and MRI.”

The coordination between UTMB OBGYNs and the breast health team plays a vital role in delivering comprehensive care, particularly when breast health concerns are identified during routine well-woman visits or exams.

“Our teams are in constant communication in order to get patients to where they need to be, whether that is for their annual visit in the office or for their screening mammograms,” Dr. Bruce said. “Patient service liaisons aid in sending reminders for patients when their crucial screening exams are due.”

The importance of screening mammography

Dr. Angelica Robinson, a board-certified radiologist at UTMB Health, said screening mammography has been proven to detect breast cancers, with the aim of identifying them at an earlier stage rather than later.

This technology has improved over the years, and early detection saves lives,” Dr. Robinson said. “For most patients, there are also factors like family history and other factors to consider.”

A notable advantage of UTMB is its emphasis on multidisciplinary teamwork. This entails collaboration with primary care physicians, OB-GYNs and colleagues on both the diagnostic and treatment sides of breast cancer, including breast surgeons, medical oncologists and radiation oncologists.

“We collaborate closely with MD Anderson for medical oncology, and as part of our approach, we convene a multidisciplinary tumor board. This entails comprehensive discussions about each individual cancer patient and their care plan,” Dr. Robinson said. “One of the key advantages of this process is that it ensures a unified and cohesive approach from the beginning to the end of the patient's journey. It allows all the physicians involved in the patient's care to be fully aligned and able to provide valuable input regarding the patient's diagnosis and treatment plan.”

It's a common misconception that if one's breasts feel fine, there's no cause for concern. However, Dr. Robinson said that's not necessarily the case. The objective of screening mammography is to detect abnormalities before they manifest as noticeable symptoms.

“The majority of breast cancer diagnoses occur in individuals who are the first in their family to be diagnosed with the disease. In most cases, breast cancer is not linked to a specific genetic cause, meaning that a particular gene is not responsible for their breast cancer,” Dr. Robinson said. “Instead, it is often considered spontaneous, occurring without a familial pattern. Therefore, having a negative family history of breast cancer does not exempt anyone from the need for annual mammograms.”

Additionally, it's important to note that there are numerous programs, including grants and philanthropic initiatives, available to assist patients who may face financial barriers to getting a mammogram.

“Regular mammograms play a crucial role in early detection and improving outcomes, and financial constraints should not be a barrier to receiving this essential screening,” Dr. Robinson said.

Support beyond treatment

Breast radiologists perform core biopsies when abnormalities are found and patients requiring surgical consultation are referred to a UTMB surgical oncologist like Dr. Colleen Silva for specialized care.

“Essentially, I am the first physician they see after receiving a breast cancer diagnosis. I serve as the gatekeeper. I am the one who manages referrals, whether it's to a medical oncologist, radiation oncologist, plastic surgeon or for any other necessary tests like CAT scans or X-rays,” Dr. Silva said. “I serve as the central point of coordination, helping patients navigate through the process.”

From start to finish, UTMB is dedicated to delivering comprehensive health care for women with breast cancer. UTMB provides dedicated navigators to help patients find their way through the system swiftly and efficiently, recognizing the distress a breast cancer diagnosis can cause. The aim of these team members is to reduce patient stress and anxiety by minimizing delays in care.

“They excel in coordinating all the additional services and requirements that patients need once they have seen me,” Dr. Silva said. “They manage their clinical responsibilities alongside their coordination of patient care. For instance, if I order a CAT scan for a patient, they ensure it’s promptly scheduled. If a patient requires consultation with a plastic surgeon, they handle all the necessary arrangements.”

UTMB's commitment to comprehensive patient care extends beyond medical treatment, as highlighted by Dr. Silva.

“We have a dedicated oncology social worker who assists patients, especially those facing financial challenges, by connecting them with community resources to meet their needs. Additionally, we offer a support group that addresses the emotional and psychological aspects of our patients' needs,” Dr. Silva said. “I believe our constant aim is to ensure the well-being of the entire patient, taking into account all aspects of their health and life.”

Tailoring care for patients

At UTMB, comprehensive breast care also encompasses post-mastectomy breast reconstruction, which can play a pivotal role in patients' healing journeys. This procedure is performed in partnership with plastic surgery colleagues at UTMB such as  Dr. Linda Phillips, chief of the Division of Plastic and Reconstructive Surgery.

“A breast cancer diagnosis is life-threatening, but it also affects your body image and your self-awareness as a woman. An asymmetrical breast, perhaps one with a contour deformity, or an absent breast can be very difficult to deal with,” Dr .Phillips said. “We may not be able to completely restore it to its original form with plastic surgery, but we can sometimes improve it and sometimes even make it look better than it did initially. A piece of knowledge like that gives women hope as they go through the process and receive treatment for breast cancer."

As part of UTMB's breast cancer program, the collaborative efforts of the medical team are key to providing personalized care that takes into account each patient's unique needs.

“With UTMB's breast cancer program, which is accredited by national organizations that provide quality evaluations, we provide quality care that is internationally recognized. These patients are discussed in conferences when we work together,” Dr .Phillips said. “In addition to conferences, we discuss patients together to ensure that our care is coordinated and as expeditious as possible. We are all responsible for caring for these patients. It is important that we tailor their care to suit their tumor, their body, their social situation and their preferences.”

Navigating plastic surgery

Depending on the unique circumstances of each patient, UTMB provides various treatment and plastic surgery plans for breast cancer patients. Jill Resendez, a plastic surgery nurse practitioner at UTMB, specializes in breast reconstruction, providing valuable services such as nipple and areola tattooing, along with extensive support to women during their breast cancer recovery.

“There are a lot of plastic surgery options available to breast cancer patients at UTMB. The plastic surgeons that specialize in oncoplastic breast reconstruction work closely with the breast surgeons such as Dr. V. Suzanne Klimberg and Dr. Silva,” Resendez said. “Depending on the patient and their situation, the treatment plan can change but there is immediate breast reconstruction following mastectomy, delayed reconstruction and so much more.”

At UTMB, patients receive unwavering support and expert guidance, especially when undergoing plastic surgery as part of their treatment.

“I often hear patients telling me that I guided them through their journey, that they always felt cared for and that they never felt forgotten,” Dr. Silva said. “Some even express that I played a crucial role in saving their lives, and that's why I'm in this profession – to make a difference. Our goal has always been to consider the patient as a whole and provide comprehensive care.”

Take the first step toward proactive breast health management by exploring UTMB's comprehensive care, starting from prevention and spanning through survivorship support, ensuring women receive the care they need and deserve.

Discover UTMB Health's network of primary and specialty care clinics and centers. Ready to book your next mammogram?  Visit the UTMB website or call 409-772-7150.