Many minds over cancer

By MARC STEWART

Staff Writer

As the war against breast cancer continues to rage, Tim Quinn, M.D., believes medicine is winning.

“Our results are getting better and better,” said Quinn, a surgeon at Kootenai Health.

“In 36 years of

practicing medicine, I have seen dramatic improvements in patient outcomes because of early detection, new drugs, improved procedures and shared knowledge between physicians.”

That shared knowledge is the cornerstone of incredibly effective collaboration from the moment someone is diagnosed with breast cancer to a cancer-free patient, said Kevin Mulvey, M.D., Medical Director of Oncology Services at Kootenai Health.

“Patients in North Idaho are getting state-of-the-art care,” said Mulvey. “Our mammography technology is much more sensitive and can identify cancer with more accuracy and then patients are rapidly referred to an oncologist. We’re also able to better identify which patients should have chemotherapy versus those who shouldn’t. The new drugs are allowing patients to live longer.”

National statistics support the belief that the tide has turned against breast cancer. According to the American Cancer Society, death rates from breast cancer in the United States dropped 39 percent between 1989 and 2015. That translates to 322,600 deaths avoided during those 26 years.

Attacking breast cancer from a team approach is at the core for Kootenai Health Clinic Cancer Services, which recently earned a center of excellence designation for its breast cancer program from the American College of Surgeons.

“We’re one of two hospitals in Idaho to have that designation,” said Teresa Johnston, the Clinical Operations Manager at Kootenai Clinic Cancer Services. “Breast cancer is the most frequently diagnosed cancer in our organization, nearly 20 percent of all cancers.”

Those figures line up with national trends.

One in eight women will develop breast cancer during her lifetime, according to the American Cancer Society. Breast cancer is the second most common cancer among women in the U.S., after skin cancer. An estimated 252,710 women will be diagnosed with breast cancer in 2017, and an estimated 40,610 women will die from it. Breast cancer risk generally increases with age. Nationally, about eight of every 10 new breast cancer cases and almost nine of every 10 breast cancer deaths are in women 50 and older.

Kootenai Health diagnosed 205 cases of breast cancer in 2016, up from 172 the previous year.

The breast cancer program uses a team approach, said Jodi Schmidt, Oncology Clinical Nurse Navigator. Schmidt is one of the first medical professionals to interact with a patient newly diagnosed with breast cancer.

“We know from experience that breast cancer is a life-altering disease,” she said. “I am here to help patients navigate their treatment from start to finish.”

From there, Kootenai Health uses a team of medical professionals called a tumor board. The breast tumor board convenes twice a month, tackling cancer cases with rigorous discussions about the best course of care and making recommendations for the patient to consider.

“We have 16 physicians on the breast tumor board and they all have different areas of expertise,” said Johnston. “They’re all able to share a patient’s records with each other and look at every avenue of care.”

Schmidt, who sits on the breast tumor board, said the group approach has made a “tremendous difference” in helping patients overcome breast cancer.

“It really has opened up better access to care,” she said. “Patients get faster, better care because all of the specialists are in one room discussing the case.”

The breast tumor board is comprised of a nurse navigator, genetics nurse, pathologist, radiologist, surgeons, medical oncologists, radiation oncologist, and a plastic surgeon, Dr. Ben Mandel.

Kootenai Health was awarded the Breast Cancer Center of Excellence designation by the National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons.

“There are 29 standards which we had to meet,” said Johnston. “We were already doing all of those things, but working toward the designation helped us put it all together.”

Accreditation by the NAPBC is given only to those centers that have voluntarily committed to provide the highest level of quality breast care and undergo a rigorous evaluation process and review of their performance. During the survey process, the center must demonstrate compliance with standards established by the NAPBC for treating women who are diagnosed with the full spectrum of breast disease.

The standards include proficiency in the areas of center leadership, clinical management, research, community outreach, professional education, and quality improvement.

A breast center that achieves NAPBC accreditation has demonstrated a firm commitment to offer its patients every significant advantage in their battle against breast disease.

“It was a lot of work to put everything together,” Johnston said. “What made it easy was that we already had most of the required things in place. It was a matter of documenting and highlighting these things. It also was made easier because we had a team of medical professionals dedicated to providing the best care to our patients.”