Case Study | March 18, 2011

Christiana Care Breast Center, Newark, Delaware

The Christiana Care Breast Center in Newark, Del., takes pride in its comprehensive, multi-disciplinary approach to breast care. Its affiliation with the Helen F. Graham Cancer Center, a National Cancer Institute (NCI)-designated Community Cancer Center, offers unique access to a wide range of services for the screening, diagnosis and treatment of breast cancer, with teams of specialists providing coordinated care every step of the way.

From screening mammography to dedicated breast magnetic resonance imaging (MRI), the Christiana Care Breast Center relies on state-of-the-art technology to deliver the highest quality care. Hologic technology plays a key role in the Breast Center, including Hologic Selenia digital mammography, Hologic ATEC breast biopsy and excision systems and the Sentinelle Medical breast MR auxillary table.

"As part of the cancer center, we are able to provide access to the broadest array of services, and our technology enables us to offer our patients the very best care," says Renie Mullaney, Breast Center Manager.

Comprehensive Care with Dedicated Breast MRI
With a team of board-certified radiologists, breast surgeons, nurses, technologists and many others within a single location, the center provides a truly coordinated approach to breast care that includes a dedicated breast MRI unit.

"It's about total care in the same center," says radiologist Jacqueline Napoletano, M.D., of the Breast Center's desire to offer dedicated breast MRI. "Typically women have to go to one place for a mammogram and then a separate location for an MRI, and if the equipment is used for other procedures, it can significantly limit accessibility for breast imaging."

Limited accessibility can significantly delay diagnosis or treatment, such as when a biopsy is required under MRI-guidance or surgeons rely on pre-operative MRI imaging for patients diagnosed with breast cancer. But at the Christiana Care Breast Center, the wait time for an MRI is days, not weeks.

Using dedicated breast MRI equipment also improves the clinical quality of the exam. For its MRI unit, the Christiana Care Breast Center chose the Sentinelle Vanguard Breast MR Auxillary Table. The table is designed specifically for breast imaging, which increases patient comfort and translates into better images, Dr. Napoletano says. The Sentinelle breast auxillary table also accommodates a wider array of body types and maximizes access to the breast, leading to easier positioning and intervention.

Digital Mammography Grows Breast Center Volume
In a facility that performs more than 20,000 mammograms per year, an efficient workflow is essential for quality care and patient satisfaction. Switching to digital mammography had a major impact on streamlining the Breast Center’s workflow and the Christiana Care Breast Center gradually replaced its four film-screen units with four Hologic Selenia digital mammography systems.

"The technology is visibly better - the images are much clearer and crisper," says Dr. Napoletano. "Digital mammography gives us a significant advantage when it comes to detecting breast cancer. Having the most up-to-date technology is the only way to practice."

To improve their interpretations, the radiologists also rely on the Hologic SecurView diagnostic workstations, which they find to be intuitive and easy to use, and ImageChecker for computer-aided detection (CAD).

"Sometimes there are things that can be overlooked, especially with calcifications or very dense breasts," says Dr. Napoletano. "CAD helps us by providing a second set of eyes, which significantly improves our diagnostic confidence."

Digital mammography's instantaneous image acquisition and electronic image management also significantly increased capacity by enabling the Christiana Care Breast Center to reduce the length of its screening appointments by half. In fact, after the Breast Center installed its first digital unit, it quickly discovered it was performing two-thirds of a day's schedule on the digital equipment.

The extra capacity led to double-digit growth in patient volume. Within the first year alone, the Breast Center’s volume increased by 14 percent, with subsequent increases of 11 percent and 16 percent over the next two years as the Breast Center continued to replace its analog machines with Hologic Selenia systems.

Efficient Interventional Procedures
For diagnostic procedures, the Christiana Care Breast Center relies on the Hologic MultiCare Platinum prone stereotactic breast biopsy guidance system, as well as Hologic ATEC breast biopsy and excision systems. The MultiCare Platinum system allows the Breast Center to offer minimally invasive breast biopsies to more women, sparing patients from unnecessary surgical excisions. The system's superior image quality enables better visualization of abnormalities, and the C-arm can be positioned at any angle through 180 degrees, providing true 360-degree access to even hard-to-reach lesions. It also enhances patient comfort, as the contoured table allows patients to lie comfortably in either direction throughout the procedure. Less than one percent of all stereotactic procedures are unable to be completed with the MultiCare Platinum system, Dr. Napoletano says.

In 2010, the Christiana Care Breast Center replaced its breast biopsy equipment with the Hologic ATEC breast biopsy and excision systems for stereotactic, ultrasound and MRI-guided procedures. The change was prompted by two key features that have improved the efficiency and comfort of breast biopsies. First, the ATEC system’s continuous pain management approach, which automatically delivers anesthetic to the biopsy site without interruption, minimizes discomfort for patients without increasing the length of the procedure.

In addition, the fully enclosed system features a dedicated chamber that automatically collects tissue samples throughout the procedure. By not having to stop to collect individual samples as they are acquired, Dr. Napoletano says the ATEC system contributes to a faster, more efficient process than the center’s previous equipment.

When it comes to selecting technology, the Christiana Care Breast Center has a long history of relying on Hologic, and the Center values both the superior technology and the outstanding support it receives from the company.

"There are some companies that sell you equipment and then disappear, so if you have a problem, there's nobody there to help you," Mullaney says. "But Hologic is always there for us."

This case study was supplied by Hologic Inc. The comments included in this publication are the opinions and personal stories of the individuals quoted and not necessarily those of Hologic. Hologic, ATEC, Dimensions, ImageChecker, MultiCare, SecurView, Selenia and Sentinelle are trademarks and/or registered trademarks of Hologic, Inc., and/or its subsidiaries in the United States and/or other countries.

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