Our Breast Care Navigators understand that a diagnosis of breast cancer is a life-altering event. We seek to help women progress forward through their breast cancer treatment in a seamless fashion. Our patient navigators help direct women through the cancer care process by helping facilitate consultation appointments, by being available to help answer questions and to act as a stable contact (a “home base”) for the patient who is often overwhelmed during the treatment process of having to see multiple physicians (breast surgeon, medical oncology, radiation oncology, radiology etc.) in multiple different offices.
"My role as a navigator is to walk with the patient and their loved ones through their breast cancer diagnosis, which can be scary and overwhelming. As the patient’s navigator, I work one on one with the patient and their treating physicians to coordinate care, to provide support and resources, and most importantly to provide compassion and comfort throughout the entire process."
Margie Hancock, BSN, RN, Breast Cancer Navigator
"Even with an early stage diagnosis, cancer care can feel complex and overwhelming. Our goal as navigators is to ease these feelings and make the process as seamless as possible. I try to ask myself, "What would I want to know if this was me."
Tessa Bair, BSN, RN, Breast Cancer Navigator
Erica Giblin, MD
Board-certified General Surgeon fellowship trained Breast Surgeon, and the medical director of the High-risk Breast Clinic.
"An ounce of prevention is worth an ounce of cure…" While we have great technology and research for breast cancer treatment, our goal at the St. Vincent High-risk Breast Clinic is to help women reduce their risk of ever having breast cancer at all or to help find it at its earliest, most easily treatable stage.
Breast screening guidelines are frequently changing and can be confusing for patients. These guidelines are based on average-risk women with no family history, no gene mutations, and no previously abnormal breast biopsies and may not apply to many women. Modern medicine encourages personalizing breast screening based on risk levels.
Our high-risk breast program thoroughly examines both a women’s personal and family history to determine their individual risk level for breast cancer and offers early detection and risk reduction techniques that would most help them. These interventions may include lifestyle changes, increased breast imaging, genetic testing, medications, and even surgical options in some cases."
Jen Hansen, A-NP
Board-certified Adult Nurse Practitioner
The High-risk Breast Clinic located at the St. Vincent Carmel Women’s Center utilizes a multi-disciplinary team specialized in breast care including breast surgeons, nurse practitioners, certified genetic counselors, radiologists, and medical oncologists.
We have a dedicated nurse practitioner experienced in high-risk breast monitoring, coordination of cancer genetic testing, and management of benign breast diseases. She works with women who are at an increased risk of developing breast cancer and provides personalized management to help reduce their risk.
Within the Clinic, we offer immediate bedside ultrasound and connect directly with the breast imaging center so patients receive accurate results promptly. This team approach ensures that the high-risk patient is provided the most up-to-date resources and a strong support team throughout her journey.
If you have a family history of breast, ovarian or uterine cancer, we have options available to decrease your risk of developing breast cancer. Women who have had a prior breast biopsy with any kind of atypia (abnormal cells) also fall into the high-risk category. At your appointment, we will educate you about all of your options: genetic testing, lifestyle changes, medications, surgical procedures, and ongoing surveillance to help decrease your risk of breast cancer.
St. Vincent Cancer Care physicians have many options for cancer patients and their loved ones. Many of today's innovative breast treatments include procedures that zero in on the tumor to help preserve breast tissue and use genetic assessments to gauge your risk and that of your family members. Predictive biomarker tests look for aggressive proteins associated with many types of breast cancer. Combination therapies (surgical, medication, and radiation) along with genetic counseling, supportive care, nutritional interventions, and rehabilitative services create holistic care – a St. Vincent cornerstone for caring for the body, mind, and spirit.
Surgical Procedures using advanced surgical techniques accelerate the healing process. Our surgeons are able to better pinpoint the tumor with more breast conserving options. Having a breast cancer diagnosis does not immediately mean mastectomy (complete surgical removal of the breast). The local excision of the tumor, called lumpectomy, often includes a treatment regime of radiation therapy and/or chemotherapy.
The MarginProbe® System uses electromagnetic waves to detect subtle electromagnetic differences between the breast cancer cells and normal breast tissue. Using this technology, the surgeon can better judge how much of the “margin” tissue needs to be removed during the lumpectomy procedure. In 3 to 5 minutes, a surgeon can test the margins and decide if more tissue needs to be removed. MarginProbe can be used during lumpectomy for both DCIS (ductal carcinoma in situ) and invasive breast cancer. This technology reduces the need to have additional surgery after the initial lumpectomy.
Video Source: SAVI SCOUT®, Cienna Medical, Inc.
The St. Vincent Breast Care Center in Carmel, IN, is the first in the nation to use the wire-free SAVI SCOUT® technology in more than 80% of patients undergoing breast-conserving therapy (lumpectomy).
Indianapolis breast surgeons have a new tool to pinpoint hard-to-detect breast tumors during surgery. Of all Ascension Breast Centers in Michigan, Tennessee and Indiana using wire-free SAVI SCOUT® wire-free technology, St. Vincent Breast Care Center in Carmel, IN, is the first in the nation to utilize the SCOUT system in more than 80% of patients undergoing breast-conserving surgery (lumpectomy).1
Before the wire-free SAVI SCOUT technology, the standard way to locate a tumor for surgical removal was to use a wire. The wire is placed into the breast to help the surgeon identify the area to be removed. The wire protrudes from the breast until the surgical removal (lumpectomy) is performed. For many women, the wire is an uncomfortable distraction, making some worry that they might move the wire out of place while moving or dressing.
Now the day of surgery can be smoother with SAVI SCOUT. Instead of using a wire, women can now have a small radar reflector (the size of a grain of rice) implanted by the radiologist in the breast at the site of the tumor. The reflector is so small that the patient will not feel this inside her breast. This tiny radar reflector is later removed with the tumor during surgery.
“Placing the SCOUT reflector is a quick, image-guided outpatient procedure that takes under two minutes,” says Larry Stover, MD, Radiology, Northwest Radiology at St. Vincent. “The patient leaves the appointment not even feeling the reflector in the breast. This alone is comforting and reassuring -- the reflector is there to essentially geo-locate the tumor.”
During the surgical procedure to remove the breast tumor, the surgeon scans the breast using the SCOUT handpiece. It detects the location of the radar reflector within 1mm. This handpiece assists the surgeon in accurately locating the reflector, along with the targeted breast tumor. This technology supports efforts on all levels to provide precision medicine in cancer treatment. The SAVI SCOUT technology gives breast surgeons valuable and precise information about the tumor location allowing the surgeon to evaluate the location of the tumor from all angles in the breast.
In November 2017, the FDA announced the wire-free radar SAVI SCOUT was cleared for long-term implantation of the reflector.”1 The radar reflector can be placed at any time. The radar reflector does not interfere with breast MRI studies, and the patient is not restricted by any other tests they may need before surgery.
“This type of radar localization allows the surgeon to plan a precise surgical approach resulting in less tissue being removed during surgery,” says Erica Giblin, MD, Breast Surgeon and Medical Director, St. Vincent Breast Care Services. “The ability to precisely locate a tumor helps to increase the probability of complete cancer removal and reduce the likelihood of needing follow-up surgeries. This is a huge advantage for breast cancer patients.”
Breast-conserving surgery (BCS) is often an option for women with early-stage breast cancer. It is also referred to as lumpectomy, partial mastectomy, or segmented mastectomy. This type of operation removes the lump (tumor) while leaving as much normal breast tissue as possible. Lymph nodes are also usually removed, and radiation treatment may be necessary. Not all women with breast cancer are candidates for BCS.
Talk to your breast surgeon to find out whether BCS with SAVI SCOUT is an option for you. St. Vincent Indianapolis, Carmel, Fishers and Evansville currently perform the outpatient procedure to place the SAVI SCOUT reflector. At St. Vincent Breast Care Services, we want every patient to be well-informed of every option, from the surgical, medical and radiation therapy treatments, to breast reconstruction, and cancer support programs.
1Cienna Medical, Inc.; (press release) FDA Clears FDA Clears World’s First and Only Wire-Free Radar Breast Tumor Localization System for Long-Term Implant Capabilities https://www.ciannamedical.com/cianna_news_releases/fda-clears-worlds-first-wire-free-radar-breast-tumor-localization-system-long-term-implant-capabilities/
2About breast-conserving surgery. https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer/breast-conserving-surgery-lumpectomy.html
Radiation therapy (also called radiotherapy) kills the cancer cells and shrinks tumors. The St. Vincent Radiation Oncology Center is at the Cancer Center on Harcourt Rd. We use both external beam radiation and internal brachytherapy for whole breast and partial breast irradiation. These treatments are designed to target the cancer cells and minimize damage to healthy tissue. SAVI and Mammosite are both available at the St. Vincent Cancer Center, on the 86th St. campus, Indianapolis.
Using the SAVI SCOUT® breast localization and surgical guidance system surgeons and radiologists can more precisely locate and guide the removal of a tumor during a lumpectomy or surgical biopsy procedure. Other breast conserving surgical benefits include:
During the procedure, the surgeon scans the breast using the SCOUT hand piece, which emits infrared light and a micro-impulse signal to detect the location of the reflector. A real-time, audible and visual indicators assist the surgeon in accurately locating the reflector, along with the target tissue. This higher level of localization precision allows the surgeon to plan a surgical approach resulting in less tissue being removed during surgery, and increases the potential for better cosmetic outcomes. The ability to precisely locate a tumor enables the surgeon to increase the probability of complete cancer removal and reduces the likelihood of needing follow-up a surgery.
Medication oncology includes chemotherapy, hormone therapy and targeted therapy, that can be given orally or intravenously to reach cancer cells anywhere in the body. Hematologists/medical oncologists affiliated with St. Vincent Cancer Care are highly experienced in the planning and delivery of combination therapies. The nurses and social workers at the Infusion Centers embody St. Vincent's caring spirit and create an environment to promote healing.
Genetic Assessment Counselors use the OncoType DX test to help breast specialists look at the activity of certain genes in the tumor tissue. Certified Genetic Counselors help patients and families better understand the risk for developing breast cancer and other cancers based on BRAC 1 & 2 gene mutations. Approximately 5-10% of women with a breast cancer diagnosis have a BRAC mutation.
Blood Marker Tests are simple blood tests used to detect cancer protein activity in the body and the presence of circulating tumor cells in the blood. Blood marker tests are both diagnostic and are used during treatment to assess if the cancer is responding the treatment or to check for recurrence.
Related breast care services such as psychological and nutritional counseling, rehabilitation services with lymphedema specialists, aromatherapy, yoga, meditation, art and exercise therapy, and support group have positively impacted the survivorship of St. Vincent breast cancer patients.