INDIANA — Dr. Dan Clark said the Indiana Regional Medical Center offers a boutique operation where each type of breast cancer patient is treated differently.
“(These days) we have reduced breast cancer at the molecular level,” said the director of the IRMC Breast Center.
“We look at the cell structure and what’s going on inside the cell and we can assess how aggressive the tumor is.”
For some, a lumpectomy is the right course of action, while others may need or choose a mastectomy.
Clark noted that he’s not there to tell people what to do.
“My role is to educate and guide, so they can make the best choice possible based on their own needs,” Clark said.
He also advises patients not to listen to other people’s stories, as what suits their own situation may be different.
“One woman’s breast cancer is not equal to another woman’s breast cancer,” Clark said.
The surgeon is part of a diverse team of medical professionals at the nationally accredited IRMC Comprehensive Breast Center that treats women from across the region.
That includes Nazneen Billimoria, Clark’s surgical partner, who has worked at the hospital for seven years.
“I think we have a great program here,” she said.
“Through our affiliation with the Hillman Cancer Center, we are able to provide our patients with the latest and most modern care so they don’t have to travel to Pittsburgh, Johns-town or Greensburg for their treatment. worry.
“The care patients receive at our breast center is the same as they would receive at larger cancer centers.”
“Have better margins”
Women usually discover abnormalities during their annual mammograms.
Clark said afterward that they are usually brought in for selective or tissue compression views.
If it is suspected of cancer, patients are then sent to radiology for a biopsy.
If the lump is determined to be cancerous, a magnetic seed is inserted into the tissue, allowing the surgeon to pinpoint the precise location of the disease.
This equipment and technique has been implemented over the past year and a half in Indiana.
Prior to the operation, the radiologist would insert a wire next to the clip previously placed on the day of the operation to let the surgeon know where the cancer was, but it was not a perfect system.
“They were very limited in their approaches and where that thread could go in,” Clark said.
“It had to be up and down and if it was an unusual place it could be a long track of skin where the lesion was.”
Because of this, the surgeon would follow the trail to that wire and remove more breast tissue than needed in some cases.
With the Mag-seed, a wire is no longer necessary.
The Surgeon uses a probe to find the Mag Seed which emits a sound and digital reading.
Both increase when the device is closer to the implant.
“So we do smaller lumpectomies and have better margins,” Clark said.
In combination with this procedure, surgeons now also have access to intraoperative imaging which takes a mammogram of the sample once it has been removed and allows doctors and the radiologist to simultaneously consult if other tissue needs to be removed. .
“We can see the biopsy clip and we can see the Mag seed in there and we can tell how close we are to the margins immediately,” Clark said.
With the implementation of these technologies, IRMC has reduced its reoperation rate from 10% to less than 5%.
“It’s a great feeling to know that we’re reducing our back surgeries by 50%,” Clark said.
“It’s a good thing to offer our patients.”
He added that it’s great for them because even though the disease is microscopic, they still feel like they’ve let the patient down if they have to tell her she needs another surgery.
Billimoria said the Mag Seed is a great addition because it allows herself and Clark to “excise smaller pieces of tissue from the breast so that the aesthetic appearance of the breast is maintained after surgery.”
“Psychological impact”
Clark’s perspective on the cancer field changed after his wife, Margaret, who is a breast radiologist at IRMC, was diagnosed with breast cancer about 12 years ago.
“I thought I knew everything about breast cancer until my own wife was diagnosed…and I went through the journey with her,” Clark said.
“I can’t even begin to talk about what she went through, but it has turned my world upside down and I think I have a much deeper understanding now of the impact that breast cancer has on individuals and their families because that I saw him hitting our kids.”
Following his treatment, his wife has been cancer-free for 11 years.
“We’ve been there, so I think it helps guide other people as well,” Clark said.
“I also have a much deeper understanding of the psychological impact of breast cancer.”
Patients walking through the Women’s Imaging Center are greeted by what Clark describes as a huge team.
In addition to itself, it has Billimoria, dedicated surgical medical assistants, nurse in officer, nurse navigator, breast radiologists and more.
Clark said Indiana Regional is building a program that will serve generations of patients.
“I just think we have a great team,” he said.
There’s also a UPMC Hillman Cancer Center on the Indiana campus, a physical therapist who’s trained in lymphedema to help patients, and Rebecca Williamson’s renewed Breast Cancer Self-Care Nutrition Program.
“We’ve improved our game on every level,” Clark said.
Center of Excellence
The American College of Radiology has provided the hospital with national accreditation for breast center programs.
This means that the center is a “Center of Excellence in Breast Imaging”.
According to the ACR website, the honor “is awarded to breast imaging centers that achieve excellence in seeking and achieving accreditation in all of the ACR’s voluntary breast imaging accreditation programs and modules. , in addition to the mandatory mammography certification program”.
To apply, center managers were required to participate in the National Mammography Database Registry, conduct ongoing self-assessment, and undergo a comprehensive assessment of the medical imaging facility, including structure and outcomes.
They also had to be fully accredited by the ACR in stereotactic breast biopsy, mammography, breast MRI and breast ultrasound, including the ultrasound-guided breast biopsy module.
Because IRMC received the title, the facility is recognized as a “Center of Excellence in Breast Imaging” for three years.
Earning that designation was one of Clark’s primary goals when he was drafted to the Indiana facility four years ago.
“It’s so great because every aspect of everyone here said, ‘What do we need to do? ” he said.
Clark noted that becoming a nationally accredited facility was no easy task.
There is also a lot of continuing education involved in the accreditation regarding himself and Billimoria.
“You have to stay on top of things,” Clark said.
Billimoria said she and Clark must complete two hours of continuing medical education a year, particularly in the area of breast cancer, to maintain their accreditation.
Clark has to do two extra hours in genetics every year because he is involved in genetic counseling and genetic testing of cancer samples.
Joshua Byers is a reporter for The Tribune-Democrat. He can be reached at 814-532-5054. Follow him on Twitter @Journo_Josh.
