During an annual breast exam, Helene Harney’s gynecologist discovered a small lump. He referred her to Advocate Christ Medical Center in Oak Lawn for a mammogram, which showed questionable results. She underwent a second mammogram, which showed tiny microcalcifications in her breast tissue. Two weeks later—following two needle biopsies and a lumpectomy—she received a phone call with the results. “I found out on my 40th birthday I had breast cancer,” says Helene. “I knew women with the disease who had died. I have a husband and four children, and I was afraid I would die, too.” Her saving grace? A referral by her surgeon Barbara Krueger, M.D., to Patrice Stephens, R.N., Christ Medical Center’s breast health specialist.

“I was in a bad place,” says Helene, “but Patrice met with me and explained everything—the risks, treatments and survival rates.” Armed with information, Helene was able to proceed with the decisions she needed to make regarding treatment. “I had a full mastectomy with breast reconstruction followed by four treatments of chemotherapy,” says Helene, “and Patrice helped me through it all.” After her surgery, Stephens supplied Helene with information that focused on recovery, including an exercise tape that would help with range of motion and prevention of arm swelling.

“During those weeks, we talked constantly and she was so wonderful,” says Helene. “She even gave me her home phone number and told me to call anytime. That meant a lot to me.”

“Helene and her husband had good questions, and they were really interested in any information I could give them,” says Stephens. “I was glad to be there for them.”

Unbelievably, three weeks after Helene’s cancer diagnosis, her mother also was diagnosed with breast cancer. Says Helene, “Patrice gave my mom the same attention she gave me.” Her mother recently finished radiation treatment, and Helene started taking tamixofen, a medication that may be useful in preventing cancer recurrence. Both Helene and her mother are doing well.

The anxiety a woman faces when she experiences a breast abnormality, needs a breast biopsy or requires breast cancer treatment can be overwhelming. That’s why the position of breast health specialist was created.

Offering education and support
“It’s important to give patients information right away,” says Stephens. “When you understand the risks, options and various treatment programs available, the wait for a diagnosis can be more bearable.”

Physicians sometimes call Stephens to their offices after they meet with the patient and have given her a cancer diagnosis. “That way, I’m there for her from the start, continuing the education and support and lending a hand to help her get through the whole ordeal as easily as possible,” says Stephens.

Mary Sue Fidale, R.N., breast health specialist at Advocate Good Shepherd Hospital in Barrington, says, “One evening, I was alerted to a woman in the hospital lobby who had been sent by her gynecologist to the hospital for a mammogram after he discovered a lump in her breast. The hospital’s mammography services were closed for the evening, and as a result, she was visibly upset.” Fidale brought the woman to her office and talked to her, giving her information on the hospital’s breast center as well as its mammography and biopsy procedures. “I helped facilitate the scheduling of her mammogram appointment and later the biopsy she required,” says Fidale. “She told me that she felt better the minute we started talking, and I know how she feels. I had a large lump removed from my breast a few years ago, and although it turned out to be noncancerous, it was probably one of the scariest things I’ve ever had to go through.”

If cancer is detected, the breast health specialist supports the woman throughout her treatment process. “We remind her that an early cancer diagnosis is good and to keep that in the forefront of her mind,” says Stephens. “In most cases, early detection is key to survival.” The breast health specialist is a constant caregiver who can recommend helpful educational resources and referrals to social workers, psychologists, support groups and medical staff. Breast health specialists often work as part of the hospital’s multidisciplinary team, which includes primary care physicians, oncologists, radiologists and surgeons.

Systemwide care
The services of breast health specialists also are available at Advocate’s outpatient facilities, including the Advocate Health Centers throughout the Chicago area and Dreyer Medical Clinic in Aurora. “If a patient requires a second ultrasound, a breast health specialist meets with her to explain the need for the additional images,” says Kari Fisher, R.N., a breast health specialist at Dreyer Medical Clinic. “The patient’s results are examined by a physician and shared with the breast health specialist. In many cases, both the physician and the specialist then meet with the patient together to explain the results and tell her if a biopsy has been recommended.” The specialist supplies the patient with helpful information and sets up an appointment for the biopsy. “We make sure before she leaves our office, she understands her results and the next steps she needs to take.”

At Advocate’s outpatient facilities, the breast health specialists also focus on general breast health. “If a woman has any type of question about her breasts, including how to perform a breast self-exam, she is referred directly to a specialist,” says Fisher. “If we can’t answer her questions, we will direct her to someone who can.”

Continued care
Breast health specialists work to ensure that emotional support of the patient is continued, even after treatment. “After surgery, all of the breast cancer patients at Good Shepherd Hospital receive a visit from a Y-ME breast cancer support group volunteer,” says Fidale. “There are a lot of good support groups for women recovering from cancer or cancer recurrences, and it’s important they know about them.”

The breast health specialists give a lot, but they get a lot in return. “It feels good to be able to help people,” Stephens says. And their special relationships don’t end when patients leave the hospital. “They really appreciate the follow-up calls because they know we still care,” says Stephens, “even when our hospital services are no longer needed.”