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Saturday, June 23, 2018

Dr. Miriam Sklar, head of the breast-imaging center at Sheba Hospital, seen with her department’s latest technology.

(Courtesy of Sheba Medical Center) Fact: One out of every nine women who live to 90 years of age will be treated for breast cancer at some point during her life. In Israel alone, more than 4,000 women will be diagnosed with breast cancer this year.

The Meirav Breast Center at the Sheba Medical Center aims to make this segment of the population beat those odds. Through their emphasis on innovation and teamwork, the doctors at the Meirav Center are succeeding in their mission to reshape the mammography experience. The center is named after Meirav Feldschuh, the daughter of former El Al CEO Joel Feldschuh. She died of breast cancer at the age of 28. According to the center that honors her name, “Her death bequeathed us a mandate to save lives.”

Today, the Meirav Breast Center treats more breast cancer patients than anywhere else in Israel and offers a full range of services including tests and treatments—all of which are provided in accordance with the individual needs of each of its patients. The center treats 4,000 patients a year. In total, the staff has performed some 12,000 mammograms, 51,000 ultrasounds, 3,200 MRIs and nearly 2,500 biopsies. The center also offers a full range of medical services including tests, therapy and specialists required for treatment. By providing multidisciplinary care to all of the patients, the center also offers much-needed and often overlooked support services including nutritional and genetic counseling, gynecological and endocrinological (hormone-related) care, physical therapy and extensive psychosocial support programs specialized for breast-cancer patients.

Leading the team is Dr. Miriam Sklar, who has been the head of the breast imaging center at the Meirav Breast Center since 2009. “I think that we are on the front lines to improve and to advance the technology,” she says. Not just limited to mammograms, the center’s dedication to personalized care allows for a variety of approaches to detection and treatment. Sklar shares some of the cutting-edge technology used to help save lives at the center. “We are also working with Israeli start-up companies in the hi-tech sector that are developing infrared imaging that does not touch the woman.”

Working with some of the best doctors in Israel, the patients at Meirav receive comprehensive treatment that is not limited to just one physician and one approach. This broad method expedites results of tests and potential treatment. Instead of waiting for days to receive results of a breast examination, the Meirav center offers not only same-day results but also follow-ups that same day.

“We perform ultrasounds on the same day and receive the report immediately and a recommendation for a follow-up; if something is found, we do the biopsy on the same day. We offer comprehensive imaging and screening and examination in one place and on the same day,” Sklar says. “We have what is needed in the event cancer is detected. We are well connected with the oncology and surgical departments and can offer treatment in one place,” she adds. However, Sklar stresses that the most important part of the treatment comes from the patient, and early detection is the key to help survive this disease. “Be proactive at any age,” she advises. “A woman should trust her intuition. If she feels something is off, she needs to check and make sure. We have the technology and the know-how to spot something as small as two centimeters. Believe yourself; if you feel like something is wrong, please insist, ask to be examined again and ask for a second opinion.”

When treatment is required, the surgical department takes over. Dr. Dov Zippel has been the director of surgery service at the center for a year and a half and is in charge of the surgical aspect of what the center does in terms of screening healthy women and treatment. “We tailor the treatment to save lives,” Zippel explains. “Everything we do is customized to a patient’s needs and each case is discussed on an individual basis and to discuss the best fit to best serve the patient.” Zippel also stresses the winning combination of teamwork and innovation.

“The treatment of breast cancer has undergone a revolution in the last few years and has become increasingly multidisciplinary. It’s not just about the surgeon. It’s about teamwork: the surgeon, the medical oncologist, radiologists and pathologists. We all get together to discuss the best treatment. Everything is personalized. Each case is discussed on an individual basis and we determine the most comprehensive fit for the patient.” The center is also dedicated to minimizing surgery.

“We try as much as we can to minimize surgeries and avoid mastectomies,” he says. Zippel points out a rising trend of “radical surgery”—where patients elect to have mastectomies and other serious operations in an effort to prevent developing cancer. “Radical surgery doesn’t improve survival; we’ve known that for 50 years. The overall number of mastectomies in the world is gradually increasing and these are more for people being scared and thinking over-treatment might mean a better chance of survival. This is not true and is something that’s very hard to come to terms with.” Zippel stresses that early detection is crucial in the fight against breast cancer. “Screening is critical and treatment in a specialized center is critical. We are the most extensive breast center in the country and we have the most experience.”