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Structure of Breast Centers

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Management of Breast Diseases

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Abstract

As breast centers in the United States began to proliferate over the past few decades, the American College of Surgeons joined forces with 20 national multidisciplinary organizations to set evidence and consensus-based standards that would ensure the optimal breast patient evaluation and management throughout the continuum of care. Since its first accreditation in late 2008, the National Accreditation for Breast Centers (NAPBC) has grown to 650 centers in 2016, including an increasing number of international centers. To gain and maintain accreditation each center undergoes a rigorous on-site inspection by a trained surveyor every three years. Preliminary data indicate that NAPBC accreditation streamlines care and improves outcomes relative to non-NAPBC breast centers.

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References

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Acknowledgments

Much of the content of this chapter is derived from the NAPBC Standards Manual [9].

Author information

Authors and Affiliations

  1. American College of Surgeons, 633 N Saint Clair Street, Chicago, IL, 60611-3211, USA

    David P. Winchester

Authors
  1. David P. Winchester
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Corresponding author

Correspondence to David P. Winchester .

Editor information

Editors and Affiliations

  1. Department of Surgery, University of Texas Health Science Center, San Antonio, Texas, USA

    Ismail Jatoi

  2. Obstetrics and Gynecology, University Medical Center Schleswig-Holstein, Luebeck, Germany

    Achim Rody

Appendix

Appendix

  • Imaging

    • Screening Mammography (Digital or Analog)

    • Diagnostic Mammography

    • Ultrasound

    • Breast MRI

  • Needle Biopsy

    • Needle biopsy—palpable

    • Image guided—Stereotactic

    • Image guided—Ultrasound

    • Image guided—MRI (if available)

  • Pathology

    • Report completeness/CAP protocols

    • Radiology-Pathology correlation

    • Prognostic and predictive indicators

    • Gene studies (if available)

  • Interdisciplinary Conference

    • Pre-and Post-treatment interdisciplinary discussion

    • History and findings

    • Imaging studies

    • Pathology

  • Patient Navigation

    • Facilitates navigation of patient through system

  • Genetic Evaluation and Management

    • Risk assessment

    • Genetic counseling

    • Genetic testing

  • Surgical Care

    • Surgical correlation with imaging/concordance

    • Preoperative planning after biopsy for surgical care

    • Breast biopsy: lumpectomy or mastectomy

    • Lymph node surgery: SNB/ALND

    • Post-initial surgical correlation/treatment planning

  • Plastic Surgery Consultation/Treatment

    • Tissue expander/Implants

    • TRAM/Latissimus flaps

    • DIEP flap/free flaps (if available)

  • Nursing

    • Nurses with specialized knowledge and skills in diseases of the breast

  • Medical Oncology Consultation/Treatment

    • Hormone therapy

    • Chemotherapy

    • Biologics

    • Chemoprevention

  • Radiation Oncology Consultation/Treatment

    • Whole breast irradiation with or without boost

    • Regional nodal irradiation

    • Partial breast irradiation treatment or protocols

    • Palliative radiation for bone or systemic metastasis

    • Stereotactic radiation for isolated or limited brain metastasis

  • Data Management

    • Data collection and submission

  • Research

    • Cooperative trials

    • Institutional original research

    • Industry sponsored trials

  • Education, Support, and Rehabilitation

    • Education (nurse) along continuum of care (pre-treatment, during, post-treatment)

    • Psychosocial Support

      • Individual Support

      • Family Support

      • Support Groups

    • Symptom management

    • Physical therapy (e.g., lymphedema management)

  • Outreach and Education

    • Community education: at large (including low-income/medically underserved)

    • Patient education

    • Physician education

  • Quality Improvement

    • Continuous quality improvement through annual studies

  • Survivorship Program

    • Follow-up surveillance

    • Rehabilitation

    • Health promotion/risk reduction

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© 2016 Springer International Publishing Switzerland

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Winchester, D.P. (2016). Structure of Breast Centers. In: Jatoi, I., Rody, A. (eds) Management of Breast Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-46356-8_34

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  • DOI: https://doi.org/10.1007/978-3-319-46356-8_34

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46354-4

  • Online ISBN: 978-3-319-46356-8

  • eBook Packages: MedicineMedicine (R0)

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