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From the Director

Since the opening of the Breast Center at SIU, we have emphasized the importance of interdisciplinary breast cancer care in the Breast Center's mission to central and southern Illinois. It continues to be our belief that interdisciplinary care offers a more comprehensive and higher quality of care to both the patient and the patient's family.

The established components of interdisciplinary breast cancer care are: 

• The development and adherence to critical pathways for diagnosis, treatment, and surveillance
• Team presentation of all treatment options
• Consensus treatment planning
• Treatment approaches guided by evidence based medicine

Patients at the Breast Center at SIU benefit from truly coordinated care with the nurse coordinator. She tracks patients throughout their entire course of consultation, treatment, and recovery to assure the appropriate resources are provided, questions are answered in a timely manner, and the patients and their families receive much needed emotional support.

Our weekly interdisciplinary conference at noon on Wednesdays provides the forum for discussion of breast cancer patients and development of a consensus for their treatment. This consensus decision is recorded and clinicians strive to deliver this plan of care with the option of returning to the forum for additional discussion as the treatment unfolds.

It has been rewarding to watch the collegiality and cohesiveness of the team develop as we have now worked together over the last several years.
We have come to appreciate the advantages of an interdisciplinary approach in breast cancer care. This approach avoids the individual ownership of patients that can sometimes occur to the detriment of the patient. The consensus approach particularly avoids specialty bias in treatment decisions. Perhaps most importantly, the approach enhances patient convenience by allowing them to see all consultants in one setting on one day and be assured that the consultants are working together in their best interest.
David Nathanson has recently published on of the first studies in literature, documenting the benefits of interdisciplinary breast cancer care. Nathanson noted increased patient satisfaction when families were encouraged to be more involved in patient support and treatment decision making. The study also noted a significant decrease in the time between diagnosis and initiation of treatment.

As Steven Corey has noted, "The main thing is to keep the main thing the main thing," and that continues to be our goal as we attempt to offer patients and their families breast cancer care that is not only state of the art and comprehensive, but interdisciplinary throughout.

Gary Dunnington, M.D.
Chair, SIU School of Medicine Department of Surgery
Director, The Breast Center at SIU