”Prof. Dr. Ion Chiricuta” Institute of Oncology
Cluj-Napoca, Romania
Social Workers
Nutritional Counselling
Survivorship Groups
Sexual Health Counselling
Supportive and Palliative Care
Integrative Medicine
Radiology
Dedicated Radiologists3
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) 2000
Dedicated Breast Surgeons 4
Surgeons with more than 50 surgeries per year 10
Breast Surgery beds 40
Breast Nurse specialists
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 1
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 4
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)
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
Medical Oncology
Dedicated Breast Medical Oncologists 4
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
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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