Life in the Fast Lane Westfield’s Noble Hospital Launches Monthly Breast Clinic

No one likes to wait. In this fast-paced world, even a few extra seconds at a stoplight or a few extra minutes in a drive-thru lane can seem like forever.

But those are trivial matters — unlike breast cancer. And for many women waiting on a biopsy appointment, they must go to multiple locations for testing over a series of days, then wait a week or two for possibly life-changing information.

That’s not ideal, said Dr. Andrew Karanas, a surgeon and physician director of the Noble Hospital Women’s Center in Westfield. And that’s one reason why Noble launched a monthly breast clinic at which women can not only undergo mammograms, but also biopsies and other tests, if necessary, right on the spot.

“The impetus for this was one-stop shopping for women with breast problems,” Karanas said.

“In general, breast care has been a little fragmented. A woman gets a mammogram, and the results are sent back to the doctor. If more studies need to be done, she’s sent back to the hospital, and then back to the internist. That’s a lot of trips back and forth. Our main impetus was to provide one setting where comprehensive evaluation and testing could be done.”

One-stop Shopping

Roberta Barron, director of the Women’s Center, told The Healthcare News that women might come to the clinic because they have found something wrong, be it a mass, a nipple discharge, or some other abnormality. Others undergo the diagnostic mammogram as part of their regular screening routine.

“Essentially,” Karanas added, “the way it works is, the woman meets me and tells me what the issues are from her perspective. I do the clinical breast exam, and if any testing needs to be done, we do it right there if possible, be it additional mammograms, ultrasound, or an ultrasound-guided biopsy. So everything is done during that visit to the clinic.”

One exception is stereotactic breast biopsy, which is not yet offered at Noble, Karanas noted. If a patient needs that procedure, the clinic refers the patient to another local hospital.

If a biopsy is performed, the results are typically available within 48 to 72 hours,” Barron said.

“What’s nice about this is that everything gets done quickly,” Karanas said. “We have the results back fairly quickly, and either I or one of my staff goes over the information with the patient.”

If the results suggest the need for surgery or some other course of action, the doctor discusses that with the patient.

“We hope this is more efficient and that we can the patient can deal with these things in a rapid way,” Karanas said. “All the waiting and shuttling between offices does create a lot of anxiety and waste, so we’ve tried to eliminate that.”

Karanas noted that although the clinic is held at the Women’s Center, it’s not a service exclusively for women. “It’s a breast clinic for women and men, although we haven’t seen men so far,” he said. “Men who have a breast problem could see us, but that’s more of a rare situation.

“For women,” he said, “the problems can range from nipple discharge to pain in the breast to the woman feeling something in the breast.”

Starting Early

Women are generally encouraged to get regular mammograms beginning in their 40s, but Karanas stressed that women of all ages are welcome at the clinic.

Certain breast issues can start in your 20s,” he noted. “Breast cancer in your 20s or 30s is extremely unusual, but it’s not impossible.”

Indeed, age is the most important risk factor for breast cancer, and the older a woman is, the greater her chance of developing the disease.

According to the National Cancer Institute (NCI), current rates suggest that 13.2{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of women born today, slightly more than 1 in 8, will be diagnosed with breast cancer at some point in their lives.

The NCI not only recommends mammograms every one to two years for women age 40 and older, but also suggests that women under age 40 should discuss their risk factors with their doctors to determine if and how often they should be screened.

The institute also argues that getting mammograms on a regular basis is the most effective way to detect breast cancer early. Like any test, the NCI notes, mammograms have both benefits and limitations. For example, some cancers cannot be detected by a mammogram, but may be found by breast examination.
The Noble clinic currently runs one Tuesday morning each month, from 9 a.m. to noon. The dates for the rest of this year are Oct. 17, Nov. 14, and Dec. 12.

“We’re hoping to add more clinic slots as volume and demand dictate,” Karanas said, “but for now it’s once a month.”