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Circle of Care

  • From Turning Point 2015

    Harold Burstein, MD, PhD, with patient Colleen Sullivan

    by Robert Levy

    Diagnosed at age 39 with stage II breast cancer, Colleen Sullivan quickly realized that "care" is a collective noun at the Susan F. Smith Center for Women's Cancers at Dana-Farber.

    Over the course of six months last year, her care team at Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) would include not only her breast oncologist, Harold Burstein, MD, PhD, but also a cancer surgeon, radiation oncologist, reconstructive surgeon, chemotherapy infusion nurse, a nurse practitioner, clinical assistants and facilitators, and a range of other professionals in the foreground and background. Had she been on a clinical trial of a new treatment, her team would have also included the investigator leading the trial, as well as other team members.


    "Because I was diagnosed at a young age and had certain receptors on my tumor cells, Dr. Burstein recommended that I see a genetic counselor," says Sullivan, a schoolteacher and mother of three young daughters. "I met with one at DF/BWCC, had my blood tested, and sure enough, it tested positive for a BRCA mutation," an inherited abnormality that can dramatically increase one's risk for breast cancer. Learning that she carried the mutation, Sullivan decided to have a double mastectomy — rather than a lumpectomy followed by radiation, as she had originally planned.

    Colleen Sullivan quote

    Now finished with her treatment, Sullivan remarks on the "many helping hands who guided me through this journey with cancer." She was particularly struck by the level of communication among those on her care team. "No matter which physician I saw, he or she had already been in touch with my other doctors," she says. "It felt as if we were one unit."

    Dr. Burstein describes the care team concept in terms of concentric circles. The inner ring includes those with the greatest contact with patients. Radiating outward are rings of other specialists — in everything from pathology to the pharmacy to nutritional counseling — who play critical, supportive roles.

    "Our patients are surrounded by a team of providers to care for them," Dr. Burstein says. "One thing that makes DF/BWCC a special place is that we are all here, working side-by-side, on a daily basis. Our clinics are arranged so that we constantly connect and interact in person — experts in every medical discipline, nurses, and laboratory scientists. Our patients feel the touch of having their medical team work together because it's real."

    As a young woman with breast cancer, Colleen Sullivan had to struggle to juggle her roles as wife, teacher, and mother of three.

    Young and Strong Program Supports Young Women with Breast Cancer

    Like Colleen Sullivan, women diagnosed with breast cancer at a young age (45 or younger) face a unique set of challenges. Many are parenting young children or thinking about becoming parents. They may also be working to advance their careers and forming important relationships. For women at this time of life, cancer can pose a formidable physical and emotional burden.

    About 11 percent of breast cancers in the United States arise in women age 45 or younger. Recognizing the distinct needs of such patients, Dana-Farber/Brigham and Women's Cancer Center founded the Young and Strong Program for young women with breast cancer in 2005.

    The first program of its kind in New England and one of the only such programs in the U.S., Young and Strong has provided care and support to thousands of patients over the past decade, helping them navigate their journey through cancer and beyond. The program recently received a major grant to expand its services.

    Directed by Ann Partridge, MD, MPH, of the Susan F. Smith Center for Women's Cancers at Dana-Farber, the program focuses on treatment as well as research. "We created the program to focus not only on the treatment of the disease — and on research to improve that treatment – but also on providing support, education, and information for our young patients and the professionals who care for them," Dr. Partridge says.

    The program's clinical services include:

    • Fertility and reproductive counseling : Physicians ensure that fertility options are addressed right away, so patients will have time to consider which is best for them.
    • Genetic testing : Patients have the option of being tested for inherited mutations to the genes BRCA1 and BRCA2 — information that can impact their treatment options.
    • Psychological support: A social worker is identified on a young woman's first visit to provide individual counseling throughout the course of treatment. The women also have access to a telephone support group, an online support group of young breast cancer patients, and mental health services.
    • Survivorship : Patients can utilize services for fertility, sexual health, weight management and other issues once they complete treatment. These young women also have the opportunity to participate in a variety of research projects designed to improve the care of young women with breast cancer in the future.

    Turning Point 2015 Table of Contents 

Posted on May 19, 2015

  • Patient Stories, Adult
  • Young Women With Breast Cancer
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