Kaiser opens new Breast Cancer Center in North Oakland

Mary Jo Sanders was used to taking care of people. As a registered nurse with 35 years of experience, the 61-year-old Richmond resident felt she understood the ins and outs of quality treatment. But when her routine mammogram led to a breast cancer diagnosis last December, Sanders suddenly found herself on the other side of the patient-provider relationship. She quickly found that receiving all the right information, care and treatment for her disease meant a lot of back and forth between doctors and departments.

“I liked my doctors but it was just a busy place over there,” Sanders said, referring to the Oakland Kaiser Permanente facility where she sought treatment. “When you first have a diagnosis, you’re frightened and anxious. I think you have greater confidence when you come in and it’s more tranquil and peaceful and things are running smooth and you see the same people—you feel safer.”

Sanders and other patients seeking breast care services now have such a space that they can call their own. Kaiser’s new Breast Care Center, which opened on October 28, serves as a stand-alone “one stop shop” for breast exams, imaging, biopsies and more.

The center, located across the street from Kaiser’s main hospital in the Howe Street Fabiola Building in North Oakland, offers a spectrum of breast health services that were formerly spread across different departments and locations.

The center has five exam rooms, three administrative offices, two procedure suites for minor operations and a resource room that houses educational materials like books and DVDs. The serene waiting area is equipped with a flat-screen TV that displays soothing nature scenes while paintings depicting swirled, rich shades of maroon and grey done by one of the center’s patients decorate the freshly painted walls. Once more space is available, the center will also host the breast cancer support group, which still meets at the main hospital.

“It’s smaller, it’s much more tranquil which I think makes one feel reassured when they come here,” Sanders said. “And there’s a certain sense of privacy—this is dedicated to breast cancer patients. So that’s been a real plus.”

Another plus, according to project manager Rachel Whalen, is the physical consolidation of services. In the past, Kaiser required patients to obtain doctor referrals to see breast specialists following abnormal mammograms. “Now they get this little hall pass and they come right up here,” Whalen said, pointing out that mammograms and lab work are done on-site. “If we need to send them for their diagnostic workup, we can get them back down there.”

According to Whalen, who has worked with Kaiser’s breast specialists for eight years, the proximity of services has greatly accelerated treatment. “When I first started, it took patients probably almost six weeks to get a diagnosis sometimes because there are so many steps in the process,” she said. “Now we sometimes can get people diagnosed in a day—not always, but there are certainly times that that happens. It’s been a significant change in a relatively short time.”

Whalen asked patients and providers to contribute to a quilt honoring Breast Cancer Awareness Month several years ago. The quilt now hangs in the hallway of Kaiser’s new Breast Care Center.

Inter-departmental collaboration has been an integral part of Kaiser’s breast health care services since Dr. Veronica Shim signed on as chief of surgery in 2002. “We’ve always been talking, even before we had a place,” said Shim, who is also the head of the new Breast Care Center. After discussion among the different experts involved in breast cancer care—including pathologists, breast imagers, oncologists, and geneticists—she said, ”We realized it would be easier for the patient if we had a physical place.”

Even before they opened the new center, Kaiser was working on ways to streamline and consolidate the various services breast cancer patients use. Whalen said Sanders’ diagnosis could have taken considerably longer had Kaiser’s integrated approach not been in place. Sanders said she was called back for a repeat test within a week of undergoing her initial mammogram. That same afternoon, she said she received an ultrasound and an hour later underwent a biopsy.

“In the past, that would’ve been another week for another appointment and then another week or two to see a surgeon,” Whelan said. “The pathway has really dramatically changed. We had started that quick turnaround over there [the former facility], but it’s easier over here now just because of location.”

And Sanders said that being able to move quickly through the treatment process helps her feel like she is playing an active role in recovery. “The toughest part about getting a negative diagnosis is waiting,” she said. “So if you’re doing something, you feel like you’re taking steps toward taking care of yourself and getting back on a healthy track. So the idea that you can do these things quickly does relieve some anxiety.”

But finding a new space for breast cancer patients to get care took some time. Shim and Whalen scouted sites for nearly five years. They chose the Fabiola Building when the neurology clinic that occupied the space relocated to Kaiser’s new Broadway medical offices, which opened in 2009.

Though many of the center’s services benefit cancer patients, Shim and her colleagues hope to provide more preventative and diagnostic services to all women, especially those who may be at an increased risk for developing breast cancer. “We really want to do early detection or risk reduction and prevention,” Shim said. One way she hopes to do that is by hosting a multidisciplinary group of medical professionals treating women with a high risk of breast cancer. Genetic counselors involved with this group evaluate patients’ risk and a team of providers from surgery, oncology, radiology and other departments determine the best course of education and monitoring for the patients. Though the high-risk team already collaborates remotely from within their own departments; they will now meet twice a month at the Breast Care Center to go over cases and diagnoses. A similar multidisciplinary committee meets once a week to discuss new breast cancer patients and plan courses of treatment.

Shim’s personal ties to breast cancer and the collaborative nature of its treatment prompted her to pursue a career in the field. “My aunt died of breast cancer when she was young, in her 40s. I remember her as somebody who really loved life,” she said. “I got into it professionally because more than any other field in surgery, you have to work as a group. It really does take a village to make the patient’s journey complete, and I kind of like that approach to care.”

Shim hopes the new center will result in more collaborative, comprehensive care. “I think more than anything, it’s nice to know when you’re going through this difficult process that you have a home,” Shim said. “I think something about that gives less stress more than anything.”

Sanders said she’s found her place at the center. Though she’s already undergone a mastectomy and completed chemotherapy and radiation treatments, she will continue to meet with Shim and her plastic surgeon at the center as she prepares for reconstructive surgery. “I sort of feel it’s my home,” she said. “I sort of take ownership of it. I feel I’m going to be connected to this facility for some time.”