Being diagnosed with breast cancer is often the beginning of a stressful and confusing time in a person's life. Obtaining information about treatment options can often help reduce this stress. The UCLA/Revlon Multidisciplinary Program was developed to provide a concise, thorough, personalized treatment plan with attention to genetic counseling and other supportive care services.
Multidisciplinary treatment is care provided by a team of specialists from different disciplines. Typically, the team includes a breast surgeon, a medical oncologist, a radiation oncologist and a plastic surgeon. Seeing all these specialists at separate appointments may be time-consuming and stressful. At the Revlon/UCLA Multidisciplinary program, all of the needed specialists will see patients in the afternoon to provide them with their evaluations and recommendations. To assist patients cope with the diagnosis and treatment, our psychosocial team, consisting of psychologists and members of the Simms/Mann Integrative Oncology team, also attend the program to provide guidance on coping techniques and supportive therapies. Genetic counseling can also be made available upon the suggestion of the team.
Breast cancer is one of the most common cancers diagnosed in the United States. Treatment decisions for individuals with breast cancer can be complicated. Our multidisciplinary approach considers the whole patient and combines cutting-edge cancer care with a nurturing, supportive environment.
The breast surgeon is often the first specialist that sees a newly diagnosed breast cancer patient. The main focus of a breast cancer surgery is to completely remove the tumor while preserving the best possible appearance of the treated breast. At the same time, the surgery also allows the surgeon to sample the lymph nodes under the arm to determine whether cancer may have spread. Tumor staging after surgery guides further treatment planning.
The medical oncologist provides recommendations regarding the need for preoperative or post-operative chemotherapy and possible hormonal blockade therapy. A medical oncologist may be involved in long-term follow-up of breast cancer patients.
A radiation oncologist focuses on reducing the chance of local recurrence after breast cancer surgery through the use of radiation therapy directed at the lumpectomy site, entire breast/chest wall or areas with draining lymph nodes. Depending on the pathology of the tumor and the particular condition of each patient, partial or whole breast treatment or other types of radiation may be recommended. Typically, radiation treatment is daily, Monday through Friday, for five to six weeks. For some people, a shorter course of radiation (e.g., three to four weeks, one to five days, single intraoperative dose) may be recommended. In some cases, radiation is not needed at all.
A plastic surgeon is available for consultation for women considering a mastectomy. Often, women opt to undergo immediate breast reconstruction at the same time as the mastectomy. For others, delayed reconstruction may be necessary. Implants or tissue flaps are the general reconstruction options available and the optimal reconstruction choice will be recommended for those considering reconstruction as part of their personalized care plan.
A psychologist will provide individual evaluations for all breast cancer patients who attend the program in recognition of this highly stressful time. For some people, individual counseling, group therapy or family support interventions have been found to be helpful during cancer treatment.
The Simms/Mann Integrative Oncology Team is part of our psychosocial team. They provide assistance with coping mechanisms and provide numerous services free of charge to breast cancer patients. Some of the services they provide include breast cancer support groups, meditation classes, art classes, spousal support groups, yoga and nutritional counseling.
For some high risk patients, a referral to a genetic counselor may be recommended as well.
What to Expect
- The Multidisciplinary Program offers a comprehensive, clear, coordinated and personalized treatment.
- Coordinated scheduling allows patients to meet with all your specialists in a single day.
- The program usually runs from 12:30 pm to 5 pm on Wednesday afternoons. Patients and their family members arrive at 12:30 pm for check-in and have a brief orientation at 1 pm.
- Each patient and his/her family and friends are then escorted to an assigned exam room where they will remain for the afternoon.
- A specialist is assigned as the "lead physician" for each patient.
- Each cancer physician then rotationally visits the patient over the course of two to three hours for consultations. Patients are encouraged to take notes or record the consultations as they ask their questions. The consultations are not time limited and each physician will remain until all questions for their discipline are answered. Depending on the treatment a patient has already received at outside facilities, not all patients need to be seen by every specialist.
- After the patient has been seen by all needed specialists, the patient and his/her family members will be given a short break. At this time, the physicians meet in our conference room to review the patient’s radiological studies and tissue slides with a radiologist and pathologist. As the case is discussed, each cancer discipline provides its recommendations for a custom treatment plan.
- The lead physician then rejoins his/her assigned patient to review all the recommendations from the cancer specialists. In addition to the verbal recommendation, a written report of the recommendations is mailed to the patient within 10 business days.
- For those patients who decide to have their breast cancer treatment at UCLA, these cancer specialists become their "team," providing the needed multidisciplinary care throughout their breast cancer journey. Follow-up appointments will be tailored according to the clinical assessment of each patient.
- All outside studies such as slides will be returned to the patient at the end of his/her consultation.
How to Begin
- Determine Eligibility: Patients with either a newly diagnosed cancer or new recurrence are eligible. Patients should contact their insurance company directly to determine coverage of an evaluation or second opinion at the Revlon/UCLA Breast Center. The cost of the program varies depending on the complexity of each case.
- Obtain a UCLA identification number. This is needed to schedule an appointment. If this is your first visit to UCLA, call (310) 301-8899 to pre-register.
- Contact the Multidisciplinary Program at the Revlon/UCLA Breast Center at (310) 825-2144 as soon as possible to schedule an appointment. All appointments are on Wednesday afternoons.
- Send medical records: All relevant medical records must be received at least 5-7 days prior to the appointment date. Records should include:
- Pathology slides and reports -- a complete set of the actual glass slides from any surgeries or biopsies of the breast
- Radiographic images and coinciding reports, including mammograms, breast ultrasounds, MRI, CT or bone scans (when appropriate)
- Blood work results within the last month
- Records from any treatments since diagnosis, including surgery, radiation treatment or chemotherapy
We suggest mailing or delivering records directly, and not relying on a referring physician to do so. Use a company with a tracking system to ensure reliable delivery. If a patient ultimately decides to seek treatment from a non-UCLA physician, all medical records that were sent or brought to the Revlon/UCLA Breast Center will be returned at the end of the appointment.