Sunday, January 15, 2012

Closer cancer care | Star-Exponent

By: Rhonda Simmons | Culpeper Star Exponent

When the new breast surgery clinic opens on Tuesday in the UVa Specialty Care-Culpeper facility, it?ll bring multidisciplinary care to local patients, minimizing the need for them to travel elsewhere for continuing outpatient procedures.

Drs. David Brenin and Anneke Schroen, both with 10 years of experience at the University of Virginia Medical Center in Charlottesville, will be available for patients on Tuesdays and Thursdays during the first and third weeks of each month at a new breast surgery clinic near the main entrance of Culpeper Regional Hospital on Sunset Lane.

Before this new specialty clinic in Culpeper, breast cancer patients would travel as far as Fredericksburg or Charlottesville to receive long-term care.

?[The new specialty clinic] will provide university-level multidisciplinary breast care to women in the Culpeper region who previously had to travel to receive such care,? said Brenin, during a telephone interview on Tuesday. ?When a woman comes to the clinic for breast cancer, her case will not only be reviewed by her surgeon, but also by a medical oncologist, radiation oncologist and breast cancer pathologist.?

Schroen echoed Brenin?s sentiments regarding the importance of bringing outpatient cancer care closer to home, saying that it takes a multidisciplinary team effort including breast surgeons, radiologists, pathologists, medical oncologists, radiation oncologists and potentially plastic surgeons to provide the best care to breast cancer patients.

?Care for breast cancer is really a long term engagement,? said Schroen, during Wednesday?s telephone interview. ?It?s not like getting a hernia repaired or an appendix removed. There are a couple of visits involved with that and that episode is over. But with breast cancer or high-risk management, that?s really not the case. The care continues over such a long period of time over many, many years. But being able to do that closer to home and to access resources that you need from multiple disciplines and to be able to do that in close proximity is really important.?

The new specialty clinic is made possible through a partnership between Culpeper Regional Health System, CRH?s parent company, and UVAMC in January 2009. The agreement involved UVa?s investment of $40 million in CRH over a three-year period, equaling to a 49 percent investment in the 70-bed Culpeper hospital. Meanwhile, CRH will remain an independent, non-profit entity with its own board of trustees.

?We are very excited to welcome Dr. Brenin and Dr. Schroen to our community,? said Lee Kirk, president and CEO of CRH. ?This clinic will provide University of Virginia Health System expertise right here in Culpeper, giving women and men in our service area easy access to the highest quality of care.?

The UVa Specialty Care-Culpeper clinic, which opened in December 2009, already houses endocrinology, infectious diseases, physical medicine and rehabilitation and pediatric cardiology under one roof.


The process

Brenin added that each patient?s case will also be reviewed by a 20 to 30-member UVa breast cancer tumor board in Charlottesville, featuring specially trained breast care doctors.

?That patient?s mammograms, pathology slides and treatment plans will be discussed amongst the entire group prior to her undergoing surgery and then again after she undergoes surgery, but prior to her receiving radiation therapy or chemotherapy,? explained Brenin. ?She not only benefits from seeing a breast surgeon, but her case will be discussed by breast cancer specialists in all of the fields that treat breast cancer. The treatment of breast cancer is not just surgery. It really involves many different modalities like radiation therapy and chemotherapy. This way patients know from the beginning from before they have surgery that these doctors will be involved in their care.?

Brenin said mainly outpatient procedures such as lumpectomies, sentinel lymph node biopsies and radiation therapy and/or chemotherapy will take place at the Culpeper clinic during afternoon hours.

During morning hours, both Brenin and Schroen will provide consultations and help patients manage breast cancer, benign breast issues and potential high-risk breast cancer cases based on family or personal history.

In terms of new equipment, Brenin explained that a new breast MRI machine will also be added locally.

?And there will be a radiologist who specializes in breast imaging. Before the radiologists were general radiologists, but as part of the new clinic, there is a radiologist that we have trained at UVa through a breast imaging fellowship.?

As far as more invasive surgery such as mastectomies and breast reconstruction surgeries, at this time, they will continue to take place at UVa in Charlottesville, Schroen said.


About the doctors

Brenin completed his residency and fellowship at Northwestern University, earning his certification in surgery in 1998. Brenin?s clinical experience includes treating high-risk breast cancer and his research interests include breast cancer tumor vaccines and focused ultrasound ablation of breast cancer.

Schroen completed her residency at the University of Texas Southwestern Medical Center, her fellowship in breast diseases at the University of Texas Medical Center and epidemiology work at the University of North Carolina at Chapel Hill. She received her surgery certification in 2002. Her clinical experience also includes treating high-risk breast cancer, benign breast conditions and her research interest consists of clinical trial accrual, access to care issues, surgical outcomes and use of new technologies.

Culpeper office hours for these breast cancer patients are from 8:30 a.m. to noon with procedures beginning after noon. For more information or to set up an appointment at the clinic call (434) 924-9479.


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