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At the Saul & Joyce Brandman Breast Center - A Project of Women's Guild, each patient receives comprehensive care from a team of breast surgeons, medical oncologists, radiation oncologists, plastic surgeons, radiologists, geneticists, nutritionists, women's health physicians, alternative medicine physicians, nurses, and physical therapists. Cases are presented at a weekly multidisciplinary conference. In this forum, multiple perspectives are considered and integrated to ensure that patients are provided the best treatment as well as the widest range of options.
Physicians are highly experienced at treating common cases as well as rare and complex cases of breast cancer. They specialize in minimally invasive surgical procedures and breast conserving surgeries.
Measuring Quality of Care at the Saul and Joyce Brandman Breast Center
To continually improve upon the care given to breast cancer patients, a number of factors that lead to high quality of care are monitored, including the volume of procedures done.
Studies suggest that for many surgical procedures, hospitals that perform high volumes have better quality outcomes, i.e. lower short-term and long-term mortality and morbidity. Volume is an indicator of experience, which influences outcomes in multiple ways. In addition to the experience of surgeons in performing specific procedures, high volume hospitals may institute specific care processes that improve outcomes and have the infrastructure dedicated to particular clinical specialties, including related technology and intensive care personnel. Commitment to quality standards throughout the institution is also an important determinant of better outcomes.1, 2 In addition, outcomes for high-risk procedures have been shown to be better when performed by more highly-trained surgeons than by general surgeons.3
|Volume of Selected Outpatient Breast Procedures and Patient Visits||Saul and Joyce Brandman Breast 2014|
|Number of patient visits to the center||12,580|
|Image-guided breast biopsy: A type of biopsy using a minimally invasive procedure like fine needle and core needle biopsy to diagnose breast lumps even when they can't be felt||837|
|Biopsy with needle localization: A type of biopsy that is done after using a process to mark the site of the suspicious area. Aided by mammography images, a radiologist inserts a needle at the site. A small amount of blue dye is injected into the site through the needle. Sometimes, the needle is replaced by a wire. Once the area has been marked, the patient goes into surgery for the biopsy.||378|
The cancer program at Cedars-Sinai is accredited by the Commission on Cancer and participates in monitoring care associated with quality-of-care guidelines for breast cancer care endorsed by the Commission on Cancer, as well as the National Quality Forum, the American Society of Clinical Oncology and the National Comprehensive Cancer Network. These quality of care guidelines include:
- Radiation therapy within one year of diagnosis for women under the age of 70 when breast conserving surgery is performed
- Combination chemotherapy is considered or administered within four months of diagnosis of breast cancer when appropriate.
- Hormone therapy is considered or administered within one year of diagnosis when appropriate.
- Radiation therapy is considered or administered following any mastectomy within one year of diagnosis of breast cancer for women with >= 4 positive regional lymph nodes
For diagnosis year 2013, Cedars-Sinai’s performance with evidence-based guidelines for breast cancer care is presented below. (Data provided by the National Cancer Database).
|Radiation Therapy is Administered Within One Year of Diagnosis for Women Under the Age of 70 When Breast Conserving Surgery is Performed||Diagnosis Year 2013|
|State of California||89.6%|
|All Commission on Cancer Approved Programs||92.4%|
|Consideration or Administration of Combination Chemotherapy Within Four Months of Diagnosis When Appropriate||Diagnosis Year 2013|
|State of California||87.7%|
|All Commission on Cancer-Approved Programs||92.8%|
|Consideration or Administration of Hormone Therapy Within One Year of Diagnosis When Appropriate||Diagnosis Year 2013|
|State of California||89.3%|
|All Commission on Cancer-Approved Programs||92.5%|
|Radiation Therapy is Considered or Administered Following Any Mastectomy within One Year of Diagnosis of Breast Cancer for Women with >=4 Positive Regional Lymph Nodes||Diagnosis Year 2013|
|State of California||84.4%|
|All Commission on Cancer-Approved Programs||90.0%|
1 Bach PB, Ann Intern Med 2009; 150:729-30
2 Greene FL, Ann Surg Oncol 2007; 15:14-15
3 Kozower BD et al, Ann Thorac Surg 2008; 86:1405-08