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Health Matters: Providence Saint John's Health Center | 7 M any changes occur at a hospital over three decades—technology is advanced and, naturally, physicians and nurses retire and new ones come on board. But throughout these changes there is always a constant at the Margie Petersen Breast Center at Providence Saint John's Health Center: a commitment to providing personalized and compassionate whole-person care to each and every patient who walks through our doors. Perhaps nobody can better attest to the continuing excellence of the breast center than Martha Andreani, who has been a patient at the breast center since the year after it opened. "It was the expertise at the Margie Peterson Breast Center that enabled my diagnosis and practical, effective surgical treatment," Andreani says. This year, we celebrate the 30th anniversary of the Margie Petersen Breast Center, which was founded in 1992 with the support of donors Margie Petersen and Joyce Eisenberg Keefer. While we honor this milestone, patients like Andreani are looking back on their decisions to seek care at the center nearly three decades ago. In 1993, Andreani, who was then the vice president of a medical professional liability insurance company, had a routine mammogram at the newly established breast center. A biopsy revealed a stage 0 ductal carcinoma (DCIS) in her right breast. Her surgeon, Armando Giuliano, MD, one of the center 's founders, performed her lumpectomy. After consulting with her oncologist, Marilou Terpenning, MD, Andreani decided against treatment with radiation due to perceived health risks and scheduling difficulties. Twenty-two years later, in 2015, a stage 0 DCIS appeared in the same breast and was surgically removed by Maggie DiNome, MD. Again, Andreani chose not to receive radiation. But when the DCIS returned seven years later, in 2022, Andreani, who is now 79 and retired, was able to take advantage of the center's advanced technology. She received intraoperative radiation therapy (IORT), a technique that delivers radiation to the tumor site during surgery, eliminating the need for whole-breast radiation and daily treatment. In addition, Janie Grumley, MD, the breast center's director, used innovative oncoplastic breast surgery techniques during Andreani's partial mastectomy, which results in more aesthetically pleasing outcomes. Dr. Grumley also performed a lift procedure on Andreani's noncancerous left breast so both breasts would be the same size. "I was pleased with the results and delighted by all these advances in care," says Andreani. DEVOTED TO THE PATIENT EXPERIENCE The Margie Petersen Breast Center has flourished in recent years with the addition of new, skilled providers and an emphasis on the whole patient, Dr. Grumley says. "Our program is designed not to be just about the cancer you have, but about who you are," she says. "We also take care of the entire patient, whether it's medical needs, emotional needs or social needs." One innovation Dr. Grumley established is the center 's Breast Health Clinic, an urgent care center for breast health. Here, women with any concerning breast symptoms, such as a lump or pain, do not need a referral by their primary care provider to consult with a breast specialist. They also can receive a mammogram or ultrasound quickly, typically within a 24-hour period. "I know how scary it is when you feel something and just want to be assessed. This breast clinic was developed to eliminate all that anxious wait time," she says. Dr. Grumley is a leader in oncoplastic surgery, a novel approach to breast-conserving surgery that combines strategic breast cancer removal with breast-lifting-and-shaping techniques, with more cosmetically pleasing results. "We've seen plastic surgeons do beautiful things," says Dr. Grumley. "Cancer surgeons are using these techniques and designing our cancer operations using similar incisions, so we can reshape the breast and not leave the woman with a deformity." The center also offers intraoperative radiation therapy. "For most women, the standard of care was, after a partial mastectomy or lumpectomy, to receive radiation therapy on the entire breast five days a week, usually taking somewhere between three to six weeks, for about 15 minutes a day," says Dr. Grumley. By contrast, IORT delivers a single dose of radiation during surgery, treating a small area around the tumor bed. "IORT has been shown to be just as effective as whole-breast radiation for women with low-risk cancers," she says. "Being able to effectively treat the site of the cancer while sparing other healthy areas like the rest of the breast, ribs, lungs and heart may have significant long-term benefits." ONE-STOP CARE Recently, two new doctors have been added to the breast center. Crystal Fancher, MD, is a surgical breast oncologist who, like Dr. Grumley, specializes in A Lasting Legacy The Margie Petersen Breast Center marks 30 years of personalized care.

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