The Breast Care Center Facilitates Care, Furthers Research
from Clinical Update, Fall 2003
Abstract: The Breast Care Center is a hub for multidisciplinary care and important research focused on breast disease, from improved diagnostic technologies to cancer prevention studies. The Center facilitates all aspects of care to minimize patient stress.
The Breast Care Center at Wake Forest University Baptist Medical Center is committed to bringing cutting-edge research to women with cancer of the breast. The multimodality consultations available in the Breast Care Center facilitate participation in research trials of a wide variety.
Having the surgical oncologist, medical oncologist, radiation oncologist, pathologist, plastic and reconstructive surgeon, and clinical and research support nurses in the clinics makes bringing protocols to the patient a daily event.
Current research trials run the gamut from prevention through the care of patients with refractory metastatic disease. WFUBMC is one of the sites for the STAR trial sponsored by the NSABP. This trial compares two proven preventive agents (Tamoxifen and Raloxifene) head to head on a national basis. WFUBMC is also the headquarters for the "Co-Star" trial evaluating the effect of prevention therapy on cognitive function of older women.
The Breast Care Center staff is excited about participation in the trial of positron emission mammography (PEM), a new technique that fuses existing technology in mammography and positron emission tomography (PET scanning) to evaluate women with breast disease. A miniaturized version of the PET imager is affixed to the compression paddles of a stereotactic breast biopsy mammography table, allowing for the ability to detect small areas with high rates of glucose meta-bolism (which would make lesions appear on PET technology). This imaging is fused with digital mammography.
Initial data suggests that PEM imaging is able to find lesions less than a centimeter in size in breasts that are otherwise difficult to evaluate. The PEM trials are ongoing, and we are currently looking for candidates.
The Breast Care Center is one of the leading sites accruing to the NSABP-B32 trial evaluating sentinel lymph node mapping in women diagnosed with cancer of the breast. In addition, we have ongoing research trials evaluating the utility of intraoperative analysis of sentinel lymph nodes. This technique has avoided second operative procedures for women with node-positive breast cancer in approximately 50% of cases.
Lymphedema is a significant problem for women undergoing nodal dissection for cancers of the breast. Although in many cases sentinel node mapping procedures can minimize this risk, other women with nodal metastases still undergo nodal dissection. WFUBMC has ongoing research trials evaluating exercise and educational interventions to avoid/minimize the effect of lymphedema on long-term breast cancer survivors.
Our chemotherapy studies include protocols for women with node-negative, node-positive and metastatic disease.
“We will always be deeply committed not only to exemplary clinical care, but to providing patients the opportunity to enroll in the latest clinical trials,” said Edward A. Levine, M.D., co-director of the Breast Care Center. “By working together as a team, we are able to streamline the process and minimize or eliminate any additional trips to the medical center for women who volunteer to be part of our clinical trials.”
Members of the Breast Care Center's team are always open to consultation or discussions with our colleagues regarding the currently available research trials.