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2011

Fairview Ridges Hospital

Oncology Annual Report

Fairview Ridges Hospital would like to thank the members of the Cancer Committee for their hard work

and dedication to improving the screening, treatment and diagnosis of patients with cancer In particular,

the Cancer Committee would like to thank Dr. Philip Dien M. D. for his many years of leadership of the

Cancer Committee. Dr. Dien was the primary driving force in the development of an oncology service for

the Fairview Ridges Hospital. As the oncology service grew, Dr.Dien was instrumental in the formation

of the Cancer Committee and subsequent accreditation at Fairview Ridges Hospital by the Commission

on Cancer.

Chair, Philip Dien, M.D.

Peter Conklin, M.D.

Matthew Gall, M.D., M.S.

Avina Singh, M.D.

Nancy Guttormson, M.D.

Timothy Kappel, M.D.

Kimberly McCollow, D.O.

Troy Scott, M.D.

Kari Hurley, R.N.

Ryan Poppinga, PharmD.

Meghan Campbell, CTR

Beth Bouman L.S.W.

Linda Reuber R.N.

Kate Cummings, R.N.

Elisa Ricciardi, R.N.

Brian Knapp Hospital Administrator

Tonya Larson, R.N.

The Fairview Ridges Hospital Cancer Committee is pleased to present our 2011 Annual Report. This

year’s report focuses on the management of breast cancer and features the services we have been able to

offer our breast cancer patients. The report reviews and analyzes our Tumor Registry data on breast

cancer, the most common cancer diagnosis at Fairview Ridges Hospital.

The Cancer Program is accredited by the American College of Surgeons Commission on Cancer and we

are proud to maintain its high standards of accreditation. At Fairview Ridges Hospital, we focus on

delivering exceptional cancer care through state-of-the-art clinical trials, utilizing national treatment

guidelines, organizing educational conferences for physicians and staff members and continually

improving and monitoring our quality of care.

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Fairview Ridges Hospital

Breast Cancer Care

Breast cancer represents the most common cancer diagnosed at Fairview Ridges Hospital. It accounted for

31.67 percent of all of the new cancer cases diagnosed at the hospital in 2010. Mammography is critical to

the early detection of breast cancer in order to achieve better outcomes. In 2010, around 10,756 screening

mammograms done at the Fairview Ridges Women’s Imaging Center.

The goal of the Fairview Ridges Hospital Cancer Program and Fairview Ridges Women’s Imaging Center

is to provide a seamless, timely and successful experience for patients who are screened and treated for

breast cancer. It is through the collaboration of our skilled physician specialists and utilization of the

resources at the Fairview Ridges that our patients receive effective cancer care. Our breast cancer team

meets monthly to review patient cases, collaborate on treatment plans, share perspectives on current

research and ensure compliance with national treatment guidelines. This multi-disciplinary team discusses

individual patients who present unique situations that can benefit from the team’s opinions. The treating

physician can take this information from our experts and discuss it with the patient to finalize a treatment

plan. Patients appreciate this type of enriched consultation and discussion. We are proud to present a team

of care providers whose collaborative efforts ensure that Fairview patients receive the most up-to-date

care in the diagnosis and treatment of breast cancer.

Radiologists: Peter Conklin, MD; Mary Foshager, MD; Steven Thiel, MD

Pathologists: Manual Guzman-Paz, MD; Timothy Kappel, MD; John Wogensen, MD

General Surgeons: Douglas Bailey, MD; Elizabeth Gavin, MD; Nancy Guttormson, MD; Ron Jenson,

MD; David Mauer, MD , Ryan Odonell, MD. Dr. Lizbeth Thomas, D.O.

Plastic Surgeon: Jacqueline Luong, MD

Medical Oncologists: Philip Dien, MD; Matthew Gall, MD; Avina Singh, MD; Eric Weinshel, MD

Radiation Oncologist: Kimberly McCollow, DO

Breast Center Navigator: Tonya Larson, RN, OCN

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Patients Benefit from Advanced Digital Technology

Patients undergo screening for breast cancer based on their age, history and risk factors. Once their

primary care physician orders a mammogram, patients have access to our fully digital Fairview Ridges

Women’s Imaging Center. The capabilities at Fairview Ridges Women’s Imaging Center exceed what is

being offered in other locations. Being fully digital means our center can provide:

Digital screening mammograms

Diagnostic digital mammograms and ultrasound

Ultrasound guided core needle biopsy

Breast needle wire localization under mammography or ultrasound

Breast MRI

Onsite radiologist

Nurse navigator

Stereotactic biopsy

When an abnormality is found and a biopsy is required, the above services are utilized to their fullest

capacity. The Nurse Navigator provides support for follow-up procedures, education, and ensures results

are reported to the patients with- in two days. This rapid notification is a priority. Once a positive biopsy

is found the team’s priority to have the patient receive the necessary consultations to begin a treatment

plan within 2 weeks. This patient is supported through this process by the Nurse Navigator.

The patient is considered for any or all of the following treatments.

Initial surgery with sentinel node injection

Options for reconstruction with Dr. Luong

Radiation therapy using new linear accelerator with capabilities for imaged guided treatment and

Intensity-modulated therapy at Ridges Radiation Center.

Chemotherapy, hormone and targeted therapies under the direction of Minnesota Oncology

physicians

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Fairview Ridges Hospital Breast Cancer Summary

Breast cancer accounted for 127 of the 401 new cancer cases at Fairview Ridges Hospital in 2010, and is

the most common cancer site diagnosed and treated at this hospital.

1. Graph of cancer by site

2. Graph of breast cancer by stage( did not see any meaningful trend)

INITIAL TREATMENT OF BREAST CANCER BY STAGE IN 2010 AJCC STAGE 0 I II III IV

No Treatment 0 0 0 0 0

Surgery 9 5 2 0 0

Surgery/Chemo 0 3 6 2 0

Surgery/Chemo/Hormone 0 5 3 0 0

Surgery/Hormone 4 12 0 0 0

Surgery/Radiation/Chemo/Hormone 0 8 4 5 0

Surgery/Radiation/Hormone 6 14 2 0 0

Surgery 12 0 0 0 0

Hormone 7 4 4 4 0

Palliative 0 0 0 0 6

Total 38 51 21 11 6

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3. Graph of breast cancer by age

4. Graph of treatment modalities by stage or in tabular form

INITIAL TREATMENT OF BREAST CANCER BY STAGE IN 2010 AJCC STAGE 0 I II III IV

No Treatment 0 0 0 0 0

Surgery 9 5 2 0 0

Surgery/Chemo 0 3 6 2 0

Surgery/Chemo/Hormone 0 5 3 0 0

Surgery/Hormone 4 12 0 0 0

Surgery/Radiation/Chemo/Hormone 0 8 4 5 0

Surgery/Radiation/Hormone 6 14 2 0 0

Surgery 12 0 0 0 0

Hormone 7 4 4 4 0

Palliative 0 0 0 0 6

Total 38 51 21 11 6

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5. Survival curves comparison with national data base

Observed Survival by Best AJCC Stage Report Fairview Ridges Hospital vs NCDB

Interval (years)

1 2 3 4 5

Stage 0

FRH (n= 30) 100.0% 100.0% 100.0% 100.0% 100.0%

NCDB (n= 24,816) 99.4% 98.6% 97.6% 96.7% 95.4%

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Interval (years)

1 2 3 4 5

Stage I

FRH (n=65) 98.5% 98.5% 98.5% 98.5% 94.8%

NCDB (n= 50,645) 99.0% 97.7% 96.0% 94.0% 91.8%

Interval (years)

1 2 3 4 5

Stage II

FRH (n=53) 98.1% 98.1% 98.1% 98.1% 93.6%

NCDB (n= 36,758) 98.1% 94.8% 91.3% 88.0% 84.8%

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Interval (years)

1 2 3 4 5

Stage III

FRH (n=19) 94.7% 94.7% 89.5% 89.5% 89.5%

NCDB (n= 13,831) 94.0% 84.9% 76.9% 70.4% 64.5%

Interval (years)

1 2 3 4 5

Stage IV

FRH (n= 4)

100.0% 75.0% 50.0% 25.0% 0.0%

NCDB (n= 4,661) 63.5% 46.7% 35.5% 27.3% 20.8%

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Trends and Accomplishments

Breast cancer remains the most common cancer diagnosed and treated at Fairview Ridges Hospital. The

trends and accomplishments for 2010 are:

The Fairview Ridges Women’s Imaging Center and improved technology has increased the

hospital’s capacity to perform timely screening and diagnostic mammograms and biopsies.

Increased use of Oncotype dx , for making treatment decisions for chemotherapy and endocrine

therapy ( in keeping with ASCO and NCCN guidelines)

New and expanded Breast Center- with access to full diagnostic imaging. Future plans include

opening of a high risk clinic with on-site genetic counselor

Education provided by a nurse navigator and multidisciplinary cancer care conference has had a

positive impact on patients.

Survival comparison was done to NCDB and the 5 year survival by stage appears to be a bit

higher in our database.(graphs attached)