Tupelo • For 20 years, the pink ribbon has run through the North Mississippi Medical Center Breast Care Center.

“There are only a handful of dedicated centers for breast imaging,” said Kyle Fallon, executive director of the NMMC radiology department.

“They’ve held themselves to very high standards … It’s all in the name of quality.”

The collaborative model with radiologists, primary care physicians, obstetrician-gynecologists, surgeons and other health professionals working closely together has remained strong.

“The breadth of the program is impressive,” said Fallon, who joined the NMMC staff in 2015.

Since the doors opened in 1999 in a wing of the NMMC Women’s Hospital, four women – technologists Kim Comer, Yolanda Deans and Amy Aven and clerical staff member Tammy Bell – have been a part of the breast care center.

“It’s a very rewarding job,” said Aven, who lives in Mooreville and joined the NMMC family in 1984.

Twenty years of hard work and dedication has paid off for the center and patients. The American College of Radiology has designated NMMC’s radiology department as a Breast Imaging Center of Excellence, accredited in mammography, stereotactic biopsy, breast MRI, breast ultrasound and ultrasound-guided biopsy.

In 2018, The Breast Care Center was a key part of NMMC breast cancer program earning the National Accreditation Program for Breast Centers from the American College of Surgeons. The demanding accreditation emphasizes a multidisciplinary approach and encompasses all of the providers who diagnose and care for patients with breast cancer including surgeons, oncologists, radiologists, pathologists and the breast care center staff. The NMMC program is only one of two in state to hold the accreditation.

“They have taken it to the next level,” Fallon said.

Spread out

Before the creation of the breast care center, mammography was spread across the NMMC campus. One room was available at NMMC Women’s Hospital for some screening mammograms, but all diagnostic mammograms had to be done in outpatient radiology at the main hospital. Parking was a nightmare, and going to the hospital for a screening test was intimidating.

“It was a big thing to walk into the main hospital,” said Deans of Saltillo, who joined NMMC staff in 1988.

Women waited in the hall of the radiology department in thin hospital gowns, while the mammographers developed the X-ray films to see if they needed additional images. Mammography films waited for the next available radiologist, along with all the other imaging studies happening in the hospital.

“Before having a dedicated radiologist, we were just in line and we would get backed up,” Deans said.

Now retired radiologist Dr. Doug Clark was a champion for creating a better system for breast imaging.

“He was the one who made the breast care center happen,” Aven said.

Clark, his fellow radiologist Dr. Marshall Edmondson and other physicians were frustrated by the long process of getting an answer for women with suspicious findings on their screening mammograms.

“I call it the anxiety interval,” Clark said.

After a screening mammogram, the radiologist would send the referring doctor a report, Clark said. The doctor would call the patient and discuss it. If there was a problem, the woman would come back for a diagnostic mammogram. Then a new report would go to the referring doctor, and then refer to a surgeon.

“It was probably two weeks,” Clark said.

Clark worked with the OB-GYNs, surgeons and primary care doctors to allow the radiologists to work directly with the patients and track the follow up exams, while keeping them in the loop on their patients’ care.

“It significantly shortened the anxiety interval,” Clark said. “They bought in and that made it work.”

The breast center staff – both clerical and clinical – made the process run very smoothly.

“It was a team approach,” Clark said. “It really, really worked well.”

Dedicated space

In 1999, the breast care center opened in a wing of the NMMC Women’s Hospital. Clark and OB-GYN Dr. Mark Ray had toured other breast care centers to help bring it to reality.

Patients had easier access to parking, and they had dedicated waiting areas for those getting mammograms. Instead of traditional patient gowns, the gowns wrapped around the body.

“We were really excited,”said Comer of Mooreville, who joined NMMC in 1999 just before the breast care center opened.

“It allowed us to make the first step,” Edmondson said.

Radiologists worked on site, so films could be reviewed quickly if additional images were needed.

Clark and Edmondson sought training so they could offer ultrasound-guided biopsies.

Soon after opening the breast care center, the first breast care fellowship-trained radiologist, Dr. Amy Ball Coleman, joined the medical staff. She was followed by breast health specialist and radiologist Dr. Susan Shamburger.

“It really made a difference,” Clark said.

Dr. Joanna Sadowska and Dr. Mary Moss are the two current fellowship-trained breast health specialists on the staff.

“It’s another level of expertise,” said Edmondson, who primarily focuses on diagnostic radiology now.

Permanent home

In October 2001, the breast care center moved into its permanent home at the corner of Eason Boulevard and Medical Park Drive. The building had previously served as the ambulatory surgery center, which had moved to a new building at 589 Garfield St. Initially, the breast care staff was worried it would retain too much of the old surgery center.

“When we walked in, it was like nothing like it was,” Deans said.

“It feels almost like a spa,” Comer added.

Patients had a large locker room with private changing areas. The robes were thick and available fresh from a warmer. Sub waiting areas were tucked into alcoves.

“It’s a long way from where we were,” Aven said.

NMMC’s leadership has been extremely supportive of the breast care center since its inception.

“They wanted to, were able and willing to invest,” Edmondson said.

Technology

Over 20 years, breast imaging technology has changed dramatically. In 1999, technologists were still taking mammograms with film.

The technologists welcomed the arrival of digital mammography in 2006. The images were improved and available instantly.

“We could see immediately if there’s a problem,” like a wrinkle in the skin, Deans said.

That significantly reduced the number of women who had to be called back for additional images and allowed the technologists to see more women.

The breast care center now does 9,800 to 10,000 mammograms annually.

In December 2017, the breast care center began to offer 3-D mammography, also called tomosynthesis. It uses the same technology as larger CT scanners, collecting multiple images as the scanner moves in an arc.

It is especially helpful for women with dense breasts, and is now covered by most insurers, Fallon said.

Ultrasound technology has also advanced, providing better images, Edmondson. It continues to be used to gather more information about areas in the breast following mammogram and to guide biopsies.

“Our technology has advanced significantly,” Edmondson said.

But without excellent technologists, the technology wouldn’t be used as effectively. The Breast Care Center has benefitted from the long tenure of its staff.

“It’s the technology and the technologists,” Edmondson said. “They’re great with patients. Everything has to work together.”

Keeping everything connected for 20 years has been the work of Bell, who joined NMMC in 1994. She tracks patient outcomes, makes sure people have follow-up appointments, makes sure referring physicians get reports.

“Tammy is the glue of the operations,” Fallon said.

Bell, a Saltillo resident, is dedicated to making sure women get the care they need, her colleagues said.

The longevity of the staff has strengthened connections with their patients. Some patients ask for the same technologist year after year. They trade stories about their children.

“We’re family,” Aven said.

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