BAP Patient Care Pathway

 

Abnormal finding by your family doctor or General Practitioner

If your family doctor has detected a change in your breast that requires further testing and investigation, your doctor will refer you to the Breast Assessment Program located at the Hotel Dieu site of Kingston Health Sciences Centre, and you will receive information about the date and time of your first appointment.

Ontario Breast Screening Program

The Ontario Breast Screening Program is part of Cancer Care Ontario that provides breast screening services for women 50 to 74 years of age, as well as women who are at higher risk of breast cancer and are between the ages 30 and 69. If a change has been detected during a recent mammogram that requires further testing, you will be referred to the Breast Assessment Program located at the Hotel Dieu site of Kingston Health Sciences Centre, and you will receive information about the date and time of your first appointment.

Diagnostic Imaging

Further imaging (testing) may include:

  • Cone compression / magnification which is a mammogram that looks at one specific area of the breast
  • Breast ultrasound is a test using sound waves that produce pictures of the breast
  • Magnetic resonance imaging also known as an MRI which makes detailed pictures of the breast and an abnormalities or changes that may have been seen on the mammogram

From here, there are two options that depend on the results of these tests:

  • A test that comes back as "normal" means that there were no worrisome features detected and you may have a return appointment with your family doctor as a follow-up and part of the routine screening process. Your family doctor will also receive a copy of the results from your tests and you should always review these results with them.
  • An "abnormal" test result means that you require additional testing and a biopsy (sample of tissue) will be arranged and scheduled for you. If after your imaging tests, you have not heard about your results, please call our office at 613-544-3400 extension 3434. Please note that while details cannot be reviewed over the telephone, a report can be sent to your family doctor so they can review and share the results with you.

Biopsy

If your imagining has shown an area that the Radiologist would like to test further, they will request a biopsy and this test will be performed with the help of a mammogram or ultrasound machine. When this appointment is booked and shared with you, it is very important that you tell the Breast Assessment Program secretary if you are currently taking any type of blood thinning medication such as aspirin, Coumadin or Plavix, as you will need to stop taking them before your biopsy appointment.

Test results:

  • A negative biopsy means that the tissue sample was benign and the Radiologist will review the pathology report and imaging results. In most cases, you may return to routine screening after this step. However, in some cases, short-term follow up with additional imaging and tests is recommended. If a follow up appointment is needed, you will receive a letter in the mail with all of the information and details.
  • A positive biopsy means that your family doctor will contact you and suggest an office visit to talk about your test results. During this visit, or telephone call, your doctor will talk about your diagnosis and what this means. You should also receive information about two other appointments. The first appointment will be with your Nurse Navigator and the second appointment will be to meet with your surgeon.

Nurse Navigator

You will have an appointment with the Nurse Navigator before you meet with your surgeon. The Nurse Navigator will support you and your family throughout your treatment and care journey. The main focus of your first meeting is to provide you with information to help you make an informed decision about your treatment. Please plan for this appointment to last up to one hour. You will also receive contact information for the Nurse Navigator.

Surgical Consult

You will meet with a breast surgeon to discuss the surgical treatment options that are available to you. Part of this appointment will involve a brief history and physical as well as a breast exam. Also, at this appointment, you will need to complete any other paperwork required before your surgery once you have a clear understanding about your treatment options and plan. At this appointment, you will receive a date for your surgery, which is generally within 2 to 3 weeks from the time of your appointment with your surgeon. Please note that Kingston Health Sciences Centre is a teaching hospital, and you may encounter doctors who are in training during your visit.

Surgery

Breast surgery is generally considered "Day Surgery" meaning you will arrive, have surgery completed and be able to go home once you are awake and stable the same day. The surgeon will come to speak with your family after your surgery to let them know how you are doing. If you need any additional care, support or follow-up with community nurses, this will be arranged before you are discharged from the hospital. The pathology results from your surgery will not be available for at least 10 to 12 business days and someone from your surgeon's office will contact you to book an appointment to review and discuss your pathology results and any further treatment plans.

Regional Cancer Centre

Additional treatment plans may be offered depending on the final pathology report after your surgery. These treatment plans may include chemotherapy, hormone therapy, radiation therapy or a combination of these and would take place at one of the Regional Cancer Care clinics . It can take up to two weeks before you meet with a specialist at the Cancer Centre, following your appointment with the surgeon. During this appointment, the doctor will discuss the benefits and risks associated with each treatment that is offered to you.

Access to Supportive Care

If you have a question, concern or need supportive care, you are encourage to call the Breast Assessment Program nursing telephone line at 613-544-3400 extension 3449. When you call, please leave a message including your full name (first and last), your date of birth, your contact information, as well as your questions, and the Nurse Navigator will make every attempt to return your call on the same day or during the next business day. Please remember that our office hours are Monday to Friday from 8:00 a.m. to 4:00 p.m. The office is closed on the weekends and during statutory holidays.

Community Referrals

Your Nurse Navigator can also provide you with contact information for local community support organizations such as Bea’s Mastectomy Boutique, Breast Cancer Action Kingston, and the Get Well Gang, as well as any other community supportive care organizations.