Developing a comprehensive breast center.

In 1985 the University of Michigan Medical Center established a multidisciplinary breast care center (BCC) to provide comprehensive diagnosis and treatment for patients with benign and malignant breast disease. Ninety-eight per cent of the first 500 new patients were women and 2 per cent were men. One-hundred thirty-one women (26.7%) and no men had breast cancer. Of the remaining 359 women, 75.3 per cent had some element of fibrocystic disease. Patients who had breast cancer were evaluated during their initial visit to the BCC by a nurse, general surgeon, radiation therapist, and oncologist. Ninety-five per cent of all patients were given a definitive treatment plan or a second opinion at the conclusion of their one visit to the center. Patient and physician satisfaction with the center concept has been high. The center emphasizes patient education and choice between mastectomy and breast-sparing procedures and radiation therapy for the control of primary cancers. Adjuvant chemotherapy or hormonal therapy is given to all nodal-positive patients. Establishment of multidisciplinary centers, such as the BCC, requires the commitment of all physician specialty groups, nursing and hospital administration. High quality patient care can be provided in such centers in a more efficient and coordinated manner than in the non-center setting. The center can serve as a source of increased patient referrals and research opportunities.