A Guide for Gift Officers

________________________________________________________

Sanford HealthSeptember 2011

2

Introduction

In December of 2010, Mr. Denny Sanford donated $100 million to Sanford Health in honor of his mother, Edith, who died of breast cancer when he was just four years old. Denny’s generous gift will be used to establish a world-renowned breast cancer center, based out of Sanford Health’s Sioux Falls, South Dakota location. To ensure long-term success, the Edith Sanford Breast Cancer foundation will be responsible for raising $100 million in annual philanthropic revenue.

About Edith Sanford Breast Cancer

Edith Sanford will decode the genetic make-up of a woman and provide her with a detailed personal snapshot of her potential risks.

Edith Sanford houses complex genetic material from our grassroots network of women to eradicate breast cancer and revolutionize treatment and the healing experience.

Edith Sanford combines advanced research, medical expertise, healthcare infrastructure, innovation through integration and a unique approach to treatment that embraces each woman and her family. With a comprehensive genetic picture from whole genome sequencing, we will know more specifically how to evaluate a woman’s risks and prevent disease, identify what treatments will work, and ultimately eradicate breast cancer.

Regardless of diagnosis, everyone can participate directly in our quest to eliminate breast cancer by giving a part of themselves to our bio bank, helping to build a database for accelerated research.

Mission

Unlock each woman’s genetic code to advance today’s prevention and treatments, and ultimately end breast cancer for future generations.

Vision

Eradicate breast cancer through personalized medicine.

Core Message

Edith Sanford Connects and mobilizes women to participate in research and raise support to treat and cure breast cancer for future generations.

3

About Breast Cancer

Nationwide, the need for inpatient breast cancer services will rise 7.8% over the course of the next decade. While the population and its epidemiologic factors – increased obesity and survivability – will drive utilization, advancement in technology will allow a shift to increased outpatient services. Additionally, earlier detection will drive a shift within inpatient services from medical care to surgical care services. Each of these indicators will allow for the development of a center that will provide the most effective, efficient care.

Yesterday:

Approximately 75% of women diagnosed with breast cancer survived their disease at least 5 years

Mastectomy was the only accepted surgical option for breast cancer treatment

Today:

In 2011, 207,090 women will be diagnosed with, and 39,840 will die of, breast cancer

Nearly 90% of women diagnosed with breast cancer will survive their disease at least 5 years

Breast-conserving surgery followed by radiation therapy has replaced mastectomy as the preferred surgical approach for treating women with early-stage breast cancer

Routine mammography screening is an accepted standard for early detection of breast cancer

The study of large groups of related individuals has led to the identification of several breast cancer susceptibility genes and some of these genes account for approximately 80-90% of all hereditary breast cancers and women who carry these genes have a lifetime risk of breast cancer that is roughly 10 times greater than that of general population

Tomorrow:

Increase the knowledge of genetics, molecular biology, and immunology to develop even more effective and less toxic treatments for breast cancer

Expand the ability to target and disrupt the effects of the molecular changes that cause breast cancer cells to become cancerous

Use this knowledge to personalized breast cancer therapy

4

With this knowledge, Sanford Health is establishing Edith Sanford Breast Cancer. It will be a special place with a team focus to lessen the burden of breast cancer by using a multidisciplinary approach to breast cancer biology/research, prevention, prediction and personalized treatment.

Creation of Edith Sanford Breast Cancer will have five primary objectives:

With Sanford Project-like focus, identify the most effective ways to approach and advance breast cancer research, diagnosis and treatment

Recruit the best research and clinical teams to develop a leading internationally recognized breast cancer research, diagnostic and treatment center

Design and construct a world-class facility in Sioux Falls Explore the opportunity for NCI designation as a Comprehensive Cancer Center

through collaboration with the Sanford-Burnham Medical Research Institute and development of the Edith Sanford Breast Cancer Research

Establish standards/protocols to create the widest range of care to patients through rational standards for clinical care and translational research enterprise wide

Edith Sanford Breast Cancer Development

Clinical Services Recruitment and Infrastructure

Sanford Health is seeking an accomplished clinician scientist and innovative research leader with a track record of building and leading clinical care and research teams. The successful candidate will have had a career as a physician and scientist with progressive administrative responsibilities in building research programs and management functions. It is important that the candidate understand how to integrate research activities within the overall patient care mission of the health system. Finally, desire to forge strong research collaborations and business relationships, a significant track record of extramural funding, publications and the ability to mentor faculty. This leader will be a world class physician scientist and leader focused on genomic medicine. In order to continue the development of this destination center, Sanford would recruit a variety of physicians, scientists and staff necessary to provide the highest level of care and research possible. Among many others with specific training and expertise in providing comprehensive breast cancer care, Sanford would seek a fellowship trained breast imager and surgeon, breast medical oncologist, molecular pathologist and oncologist, a radiation oncologist and a designated genetics counselor. Following the development of these practices to maturity, and as dictated by appropriate market and industry demographics, Sanford would recruit fellowship trained plastic and breast surgeons, a designated psychologist and a palliative care physician.

5

Research

Like many sites around the world, the Edith Sanford National Breast Cancer Institute will provide high-quality health care for patients during screening and those diagnosed with breast cancer. Patients at the Center will ultimately all be considered research subjects, in that they are invited to become partners with the program. The selected Director will establish the most forward thinking and approaching application of “personalized medicine”. Breast Cancer patients will have their genomic, proteomic and metabolomic status collated with the most dynamic of these biological readouts monitored as a function of their cancer. Information gathered from their dataset, as well as data gathered from their cancer, will be integrated to understand not just localized cancer, but also host response that renders an individual susceptible to metastatic cancer. The goal is to create an outcome of higher quality of life and more cancer-free women.

Bio Bank Development

• While awaiting identification of the leader of this program, Sanford Health is developing the critical infrastructure for a bio bank. Space has been identified and a Director and staff are in place and developing work flows for collection, cataloguing, storing and archiving samples. IRB protocols have been developed and initial gathering of specimens has begun.

• Expansion of process to breast tissue collection is scheduled to begin in January, 2012.

• Development of the bio bank is critical to the application of personalized medicine. The bio bank Director will be responsible for further development of this resource as well as oversight of the entire Breast Cancer initiative.

6

Edith Sanford Facility in Sioux Falls

The facility will support services and programs providing outpatient, nonsurgical inpatient services and research. The spatially unified facility will be patient centric in design and be a “game changer” based on the patient experience provided within its walls. Environmental factors include visual senses, auditory, smell, touch and taste. Drastic variance in surroundings can be problematic for patients as they as they move through the transitions of care and expectations are not met consistently. Facilities must support this journey through care.

The National Breast Center building will be 41,000 sq. ft. The lower level is 16,000 sq. ft. and will be enclosed for future Radiation Oncology build out. The Ground Level and Level 1000 will be finished and be a total of 25,000 sq. ft.

This space will include:

• A Grand Lobby to include a Navigation Center which will help patients move through the various phases of their cancer journey.• Bloom/HME (breast prosthesis/fitting)• Breast Health Imaging• High Risk Breast Clinic• Genetic Counseling• Oncology Behavioral Health• Breast Focused Oncologist Clinic

• Breast Surgeon Clinic• Rotational Clinics (Head & Neck, GYN Onc etc)• Multidisciplinary Clinics (Lung, Liver, Pancreas)• Cancer Acute Care Clinic• Breast Infusion• Clinical Research Space to include Phase I Multidisciplinary Center and Clinical Research Assistant space

7

Edith Sanford Medical Staff

David A. Pearce, PhD

[UPDATED CV OVERVIEW HERE]

H. Eugene Hoyme, MD

Practice SpecialtiesMedical GeneticsPediatricsPediatric-Genetics

Dr. Hoyme is Professor and Chair of the Department of Pediatrics, Sanford School of medicine of The University of South Dakota and Chief Pediatric Medical Officer at Sanford Children’s Hospital.

Education:Medical SchoolUniversity of Chicago, Pritzker School of MedicineResidencyPediatric Residency from the University of California, San Diego School of MedicineFellowshipFellowship in Clinical Genetics and Dysmorphology from the University of California, San Diego School of MedicineCertifications

8

Certified in General Pediatrics by the American Board of Pediatrics; and in Clinical

Genetics and Clinical Cytogenetics by the American Board of Medical Genetics

Edith Sanford Breast CancerFrequently Asked Questions

Q: What is Edith Sanford Breast Cancer?A: Through a major expansion of Sanford Health’s research and clinical care programs, Edith Sanford Breast Cancer will explore a woman’s entire genetic puzzle to advance personalized medicine, understand why breast cancer develops and unveil discoveries that will more effectively treat, prevent and end breast cancer for future generations.

Q: How will Sanford Health use genomics as part of this initiative?A: Sanford Health believes personalized medicine and genomics is the key to fully understanding this disease and discovering a cure. Sanford Research will collect genetic samples from volunteers as part of a comprehensive bio bank to accelerate research. Researchers will also study the genetic code unique to women and to the breast cancer disease in an effort to unlock the cure to breast cancer, tailor treatment to each woman’s genetic predisposition, prevent the disease and ultimately, eradicate it.

Q: What is the bio bank?A: The bio bank is part of Sanford Research and will house a collection of genetic samples (blood and tissue) from women that will allow researchers to accelerate their study into breast cancer genetics. Our vision is to create a genetic repository unlike anything available today for breast cancer research.

Q: Who will lead this initiative?A: Sanford Research is currently conducting an extensive nationwide search to select a physician-researcher director for this program.

Q: Where will the breast cancer care be provided as part of Edith Sanford Breast Cancer?A: The healing and treatment experience will be centralized in the Edith Sanford Breast Cancer Center, a new facility to be constructed between the existing Sanford Health Cancer Center and VanDemark buildings, facing the Sanford Health Medical Center in Sioux Falls. The Edith Sanford Breast Cancer Center, with construction beginning next year, will provide an innovative platform where the latest in research can be seamlessly translated to care across Sanford Health’s entire system, with plans also including a future expansion of the Roger Maris Cancer Center in Fargo.

The Edith Sanford Breast Cancer Center will build and expand upon the organization’s current nationally accredited care, as Sanford Health includes one of the first 51, or mere five percent, in the United States to receive National Breast Center Accreditation

9

administered by the American College of Surgeons. Sanford Health is also a participant in the National Consortium of Breast Centers in the U.S., initiated to engage patients around the quality of their care.

Q: How will the $100 million Denny Sanford gift be used??A: A significant gift from T. Denny Sanford, in honor of his mother who died of breast cancer when he was a boy, serves as the catalyst to spur and cultivate the long-term support required for the Edith Sanford Breast Cancer program of work.

Q: How is Mary Hart connected to this initiative?A: Mary Hart is a South Dakota native and television celebrity. Her mother is a breast cancer survivor. Out of her personal connection and enthusiasm for the work of Edith Sanford Breast Cancer, Mary Hart is serving as a national spokesperson for the cause..

Q: What is the symbolism behind the Edith Sanford Breast Cancer logo?A: You’ll notice 11 hexagons on the strands of Edith’s signature. One stands for Edith, one for Denny and one for Sanford Health as we unite in this cause. The remaining eight, however, are at the heart of this movement, representing today’s daunting reality of one in eight women being diagnosed with breast cancer, the most common cancer women face today.

10

Sanford Health Announces Groundbreaking Breast Cancer Initiative

Edith Sanford Breast Cancer to Pursue Novel Research to Transform Care and Find a Cure

On August 17, 2011 new hope was born in the fight against breast cancer. During a special event in Sioux Falls, Sanford Health unveiled plans for Edith Sanford Breast Cancer, which will include a state-of-the-art treatment center and an extensive research endeavor that will take genetic research to a new level.

The event drew nearly 400 invited guests and featured Mary Hart, retired host of the television show Entertainment Tonight. At the event, Hart, a Sioux Falls native, described how breast cancer affected her family by claiming the life of her grandmother and afflicting her mother as well. “Breast cancer broke up the family, and it’s something that we intend to end,” said Hart, who also announced that she would be the national spokesperson for Edith Sanford Breast Cancer. “There is one thing today that we all have in common in this room, and that is that we are impatient,” she said. “We want it to end now. We want to find the cure to breast cancer.”

Philanthropist T. Denny Sanford made a gift of $100 million to establish Edith Sanford Breast Cancer, named for his mother who died from breast cancer when he was four years old. “This is in my mother’s honor, but it is also in honor of all of our special loved ones,” said Sanford, referring to the one in eight women who are diagnosed with breast cancer at some point in their lives. “Thanks for standing with us and by us as we launch this great cause,” he said.

President of Sanford Research Eugene Hoyme described the novel approach of Edith Sanford Breast Cancer, which will involve “second-generation whole-genome sequencing.” The result will be finely tuned treatment that is tailored according to each woman’s genetic make-up. Ultimately, he said, Sanford Health expects the research to help lead to a cure.

With a cutting-edge “BioBank” in place to store genetic information, Edith Sanford Breast Cancer will call upon women across the country to donate blood samples to equip researchers for groundbreaking discoveries, announced Becky Nelson, Sanford Health’s Chief Operating Officer. “Regardless of diagnosis, everyone will be able to participate directly by contributing to our unique and advanced database for accelerated research,” she said.

11

Nelson introduced to the audience the founding donor to the BioBank, Lou Waltner, a 61-year-old barista at a Sanford Health café. Waltner lost her mother to breast cancer and is currently undergoing treatment for the disease. “I am proud to work for an organization that is making breast cancer a priority,” said Waltner, who was one of 25 women recognized at the event for inaugurating the BioBank. “I want to thank you on behalf of everyone touched by this disease, and I also want to thank Mr. Sanford for making this possible.”

“I hope you get a sense of the kind of commitment and the kind of passion that is coming out of Denny Sanford and immediately into the Sanford [Health] family here,” said Kelby Krabbenhoft, chief executive officer of Sanford Health. “We feel the finish line is in sight,” he said of the search for a cure.

Mary Hart underscored the need for broad participation for the effort to be a success. “This is going to be a very important grassroots effort that we want all of you to be a part of,” she said.

“I want you to know how meaningful it is to me to be a part of this remarkable organization,” Hart added. “Now I can say ‘I’m not going to hang out with Tom Cruise and George Clooney any more—I have Denny and Kelby—and […] I’m going to help find a cure for breast cancer.’”

About Sanford Health

Sanford Health is an integrated health system headquartered in Fargo, ND and Sioux Falls, SD and consists of two long-standing organizations that merged in 2009. Sanford is now the largest, rural, not-for-profit health care system in the nation with a presence in 112 communities in seven states. In addition, Sanford Health is in the process of developing an international clinic in Ireland.

Sanford Health includes 34 hospitals, 116 clinic locations and more than 900 physicians in 70 specialty areas of medicine. With more than 20,000 employees, Sanford Health is the largest employer in North and South Dakota. The system is experiencing dynamic growth and development in conjunction with Denny Sanford's $400 million gift in 2007, the largest gift ever to a health care organization in America. This gift is making possible the implementation of the several initiatives including global children's clinics, multiple research centers, eradicating breast cancer and finding a cure for type 1 diabetes. For more information, visit sanfordhealth.org.

12