Transcription:

Deborah Howell (Host): This is Mission In Action, a podcast from St. Mary's Healthcare in Athens, Georgia, focusing on patient centered care under our mission to be a transforming healing presence within our communities. I'm Deborah Howell.

Today, we'll be talking about breast health and also about the value of a Breast Center to individuals and to the community. Our guest is Dr. Kathleen Jeffery, a Breast Surgeon at St. Mary's Healthcare. Welcome Dr. Jeffery.

Kathleen Jeffery, MD (Guest): Thank you. Thank you for having me.

Host: So when should someone be seen in a Breast Center?

Dr. Jeffery: So, a lot of people think that Breast Centers are only about people with breast cancers, but there are many different diseases we see at a Breast Center. So, obviously we do see patients with breast cancer. However, there are a lot of conditions of the breast that need evaluation as well. Obviously some of those are just benign tumors within the breast, lumps that women will feel in their breasts. We will also see people with nipple discharge. One big problem that's prevalent in women is breast pain. So, women that have breast pain and evaluate that and make sure there's no other treatable condition underlying that, that we can make their life a little better by treating. The other thing we will see frequently, is people at high risk.

So, there are people that have family histories that are concerned about their personal risk or that have high risk based on their mammograms and would like to be seen by a Breast Center or in a Breast Center, to further evaluate that and make sure there's not something they should be doing more vigilantly on their side for surveillance.

Host: Sure. And then some might ask why a dedicated Breast Center instead of a general office.

Kathleen Jeffery, MD (Guest): Because I think at a dedicated Breast Center, we are focused on the appropriate care that needs to happen with breast patients and keeping up with NCCN guidelines and national standards for what needs to be done for Breast Centers. Plus you have people that, that is their primary interest. They're dedicated to the care of women with breast conditions and diseases. I think that there's a passion involved with it. And I think that, that's what you're looking for in a Breast Center and people that are integrated and can connect you to the right places to go. There are places that certainly see breast conditions, but they also see hernias. They also see colons, that is not their specialty. And I think that's where you get the elevated level of care.

Host: Absolutely. And you do see men too as well?

Dr. Jeffery: Absolutely. We see plenty of men. We see men with not only breast cancers, unfortunately, but also with conditions where their breasts will enlarge. And we want to make sure there's nothing else going on and we can treat those as well, at our center. So, we see a fair number of men. We also see men additionally for genetic testing.

Host: Oh, amazing. I didn't know that. So, what could I expect no matter what my gender is at a typical visit?

Dr. Jeffery: So, at a typical visit with the Breast Center, you'll be, obviously you'll come in. You'll do the first thing we do on every single patient, no matter what you're coming in for is a risk assessment. And that's just one way we have to evaluate every patient that comes through to make sure that we're not missing something.

They may not be here because of their concern about risk. But many times when we see patients for, let's say it's breast pain and we do that risk assessment as part of our intake, we find out hey, by the way, you're at high genetic risk. And then we can pursue that as well. And patients are very relieved to know that they're going to have a comprehensive evaluation. They're not just coming in to be looked at for that one specific problem. We're going to look at the entire breast history, not just the thing they came in for.

Host: Sure. And since you brought it up, let's talk about high risk clinics. What do we need to know?

Dr. Jeffery: High-risk clinics are becoming very important I have found. I've started a high-risk clinic at another facility, and that was an important part of me coming to St. Mary's. I said, you know women are very intuitive these days, they're doing their research. They want to know that they're being proactive and that's where the high-risk clinic comes in.

So, you know, many patients don't want to get to the point where they have cancer and then treat the cancer. We want to see is there any way we can kind of address things before they are a problem. So, can we do genetic testing and say, hey, this individual actually has a genetic mutation. Now we need to pursue a different path with them to prevent breast cancer developing in them, or prevent any kind of cancer that might be related to that genetic mutation for instance, or on the flip side of that, not just for genetic mutations, but some women, when they get their mammograms at a good institution like ours at St. Mary's, they will get a risk assessment when they come in for their mammogram. At that risk assessment, they may be told they're high risk and MRIs may be recommended.

Well, a lot of women start to get nervous when they hear this. So, we bring them into our situation and then we follow them for high risk surveillance. So, if we decide that this patient yes, does qualify for adding MRIs to their surveillance plan, then we will see them yearly or every six months, depending on what's appropriate to kind of reassure them, make sure all their x-rays are normal, make sure nothing's changed. And that we are being very preventative in those cases.

Host: Perfect. And we've talked a little bit about these, but what are some of the services that a Breast Center offers?

Dr. Jeffery: So in a Breast Center, obviously we have addressed that we do do genetic counseling. We do genetic testing. We do in office ultrasound, which is very nice. So, if a patient comes in that day with a lump, for instance, we can ultrasound them that very day. And do a biopsy potentially that day.

So there are biopsy services that day in a Breast Center. We are looking forward to adding a mammogram to our program as well. So, we could do everything from getting your mammograms, getting your ultrasound, doing your biopsies, both under mammogram and ultrasound, as well as seeing the Breast Surgeon and getting treatment from them.

Host: That's amazing. You know, I've always wondered what's a tumor board?

Dr. Jeffery: So, a tumor board is where we bring in all disciplines that are involved in the care of breast patients. And it's surprising to people, but there are a lot. So, you not only have the Breast Surgeon, but you have the Breast Radiologist, you have the Pathologists reading the breast specimens that we send them. You have the Radiology that reads the mammograms. You have the Radiation Oncologist that might help in treating breast cancers. You have the Medical Oncologists that help treating breast cancers. You also have our Breast Navigators. Our Breast Navigators are people that are very important to our program with breast care because they are the liaison between the doctors and the patients to make basically the doctors more accessible to the patients and get answers to the patients which are important because patients often have questions that go unanswered and we tell them emphatically, you can always get ahold of our Breast Navigator if you have a question, almost always, they can address that question.

If they can't, that will deflect to the doctor. In the tumor board, we also have our tumor registry people, our plastic surgeons. So, there is a whole team of experts that comes together and talks about these patients. And then that way you don't just have one physician making decisions. You have a lot of minds coming together for the best possible treatment and outcomes for patients.

Host: I love a good consensus. So, Dr. Jeffery, tell us a little bit more about the kind of care a patient receives at a Breast Center.

Dr. Jeffery: So, I think the important thing of a Breast Center for patient is that when a patient has a breast problem and it doesn't have to be cancer; it's a very stressful anxiety provoking situation. And our job at a Breast Center is to bring that level of anxiety down in a calming environment where we feel like we can not only educate our patients, that they can make the best decisions, but also where they feel like they're getting seamless care.

So, they are being guided through the process very seamlessly to the right people. All the appointments are given very clearly. They don't feel like there's a lot of unanswered questions and that's our goal for a Breast Center that it's very well-integrated with all the different aspects of breast care and it flows as well as it possibly can to keep the level of anxiety down or as low as possible.

Host: I'm sure you have some difficult conversations with your patients, but what's the best part about your job?

Dr. Jeffery: The best part of my job is getting to know my patients and becoming part of their life, part of their care. I take it very personally. I want them to feel like I am their advocate, that I care about them and that their treatment and they're doing well is the most important thing to me.

But not only from a physical standpoint, from an emotional standpoint. I want to connect with my patients. I have so many patients from years and years ago that I still have relationships with, and that's the most important thing about me that longitudinal care, getting to know their families and the people involved in their lives, in the process. I think that's probably the thing that I enjoy the most about my job.

Host: Well, what a gift to a patient to have a physician who truly, truly cares. How can people make an appointment Dr. Jeffery?

Dr. Jeffery: You can always call our office at (706) 425-5437. But there's also the website through St. Mary's for the St. Mary's Breast Health Center, where they can make an appointment through that as well.

Host: And I'll give that in just a second. We want to thank you so much, Dr. Jeffery for taking time out of your day, to give us your expertise and to shine a light on Breast Centers and their unique benefits.

Dr. Jeffery: Thank you so much, Deborah. I appreciate the opportunity to share it.

Host: And for more information, please visit www.St.Mary'shealthcaresystem.org. This has been Mission In Action, a podcast from St. Mary's Healthcare in Athens, Georgia, focusing on how we provide patient centered care under our mission to be a transforming healing presence within our communities. Thanks for listening.