
Centro Hospitalar Lisboa Central
Lisbon, Portugal
Social Workers
Nutritional Counselling
Survivorship Groups
Sexual Health Counselling
Supportive and Palliative Care
Integrative Medicine
Radiology
Dedicated Radiologists4
Mammograms per year3000
Breast radiographers
Screening program
Verification for non-palpable breast lesions on specimen
Axillary US/US-guided FNAB
Clinical Research
Available imaging equipment
Mammography
Ultrasound
Magnetic Resonance Imaging (MRI)
Available work-up imaging equipment
Computer Tomography
Ultrasound
Magnetic Resonance Imaging (MRI)
PET/CT scan
Primary technique for localizing non-palpable lesions
Hook-wire (or needle localization)
Charcoal marking/tattooing
ROLL: radio-guided occult lesion localization
Available breast tissue sampling equipment
Stereotactic Biopsy (Mammography guided)
Core Biopsy (Tru-cut)
Vacuum assisted biopsy
Ultrasound-guided biopsy
Fine-needle aspiration biopsy (FNAB, cytology)
Core Biopsy
Vacuum assisted biopsy
MRI-guided biopsy
Core Biopsy
Vacuum assisted biopsy
Breast Surgery
New operated cases per year (benign and malignant)
346
Dedicated Breast Surgeons
5
Surgeons with more than 50 surgeries per year
4
Breast Surgery beds
5
Breast Nurse specialists
3
Outpatient surgery
Intra-operative evaluation of sentinel node
Reconstruction performed by Breast Surgeons
Clinical Research
Primary technique for staging the axilla
Axillary lymph node dissection
Sentinel lymph node biopsy:
Blue dye technique
Radio-tracer technique
Blue dye + Radio-tracer
Axillary sampling
Reconstructive/Plastic Surgery
Reconstructive/Plastic surgeons
2
Immediate Reconstruction available
Type of breast reconstructive surgery available
Remodelling after breast-conserving surgery
Reconstruction after mastectomy:
Two-stage reconstruction (tissue expander followed by implant)
One-stage reconstruction
Autogenous tissue flap
Latissimus dorsi flap
Transverse rectus abdominis (TRAM)
Free-flaps (free TRAM, DIEP, SIEA, gluteal, etc.)
Surgery on the contralateral breast for symmetry
Pathology
Dedicated Breast Pathologists
2
Available studies
Cytology
Haematoxylin & eosin section (H&E)
Surgical specimen
Sentinel node
Core biopsy
Frozen section (FS)
Surgical specimen
Sentinel node
Immunohistochemistry stain (IHC)
Estrogen receptors
Progesterone receptors
HER-2
Ki-67
Other special studies available
Fluorescence in-situ Hybridization for HER-2 gene (FISH)
Oncotype Dx (21-gene assay)
MammaPrint (70-gene microarray)
Prediction Analysis of Microarray 50-gene set (PAM 50)
OSNA
Parameters included in the final pathology report
Pathology stage (pT and pN)
Tumour size (invasive component in mm)
Histologic type
Tumor grade
ER/PR receptor status
HER-2/neu receptor status
Peritumoural/Lymphovascular invasion
Margin status
ki-67
Medical Oncology
Dedicated Breast Medical Oncologists
3
Outpatient systemic therapy
Clinical Research
Radiotherapy
Dedicated Radiation Oncologists
Clinical Research
Available techniques after breast-conserving surgery (including experimental)
Whole-Breast RT (WBRT)
Partial breast irradiation (PBI):
External beam PBI
Interstitial brachytherapy
Targeted brachytherapy (MammoSite, SAVI applicator, other devices)
Intra-operative RT (IORT)
Multidisciplinary Meeting (MDM) / Tumour Board (TB)
Regular MDM/TB for case management discussion
Twice a week
Weekly
Every two weeks
Other Schedule
Cases discussed at MDM/TB
Preoperative cases
Postoperative cases
Specialties/services participating in MDM/TB
Radiology
Breast Surgery
Reconstructive/Plastic Surgery
Pathology
Medical Oncology
Radiotherapy
Genetic Counselling
Breast Nurse Service
Psycho-oncology
Social worker
Further Services and Facilities
Nuclear Medicine
Lymphoscintigraphy
Bone scan
Positron Emission Tomography (PET)
PET/CT scan
Rehabilitation
Prosthesis service
Physiotherapy
Lymph-oedema treatment
Genetic Counselling
Specialist Providing Genetic Counselling/Risk assessment service:
Dedicated Clinical Geneticist
Medical Oncologist
Breast Surgeon
General Surgeon
Gynaecologist
Genetic Testing available
Surveillance program for high-risk women
Data Management
Database used for clinical information
Data manager available
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