Garibaldi Hospital Nesima - Catania, Italy

General Information

New breast cancer cases treated per year 348

Breast multidisciplinarity team members 16 Radiologists, surgeons, pathologists, medical oncologists, radiotherapists and nurses

Clinical Director: Giorgio Giannone, PhyD

Garibaldi Hospital is a cancer centre specialized in diagnosis, treatment, care and education. It is located on the west part of the city in Via Palermo No. 636 and it consists of 3 towers (Tower A, B and C). The Breast Unit is on the 4th floor of Tower B and it houses 4 beds for in-patient and out-patient admissions. The rooms are comfortably equipped with wardrobes, night tables, private bathroom, T.V. set, telephone, air conditioning, and central heating. It has a dedicated operating theatre with two sessions for breast surgery and benign pathology, as well as an operating session for plastic surgery. It provides clinical breast examinations and post-operative check-ups 5 days a week. It performs around 348 cancer cases per year including benign tumours. A multidisciplinary team, made up of different healthcare professionals, meets regularly to discuss the best treatment options for each patient in its care. In addition, the Breast Unit provides information, support and advice to people with cancer, to their families and friends, and it has links with SOS Donna, a non-profit voluntary association for breast cancer awareness.

Garibaldi Hospital Nesima Via Palermo 636 95122 Catania, Phone: +390957591111 Fax: +390957595529 E-mail: [email protected] Web-site: www.ao-garibaldi.catania.it

1/6 Garibaldi Hospital Nesima

Available services

Radiology Nuclear Medicine Social Workers Breast Surgery Rehabilitation Nutritional Counselling Reconstructive/Plastic Surgery Genetic Counselling Survivorship Groups Pathology Data Management Sexual Health Counselling Medical Oncology Psycho-oncology Supportive and Palliative Care Radiotherapy Breast Nurses Integrative Medicine

Radiology

Dedicated Radiologists 3 Available imaging equipment Available breast tissue sampling Mammograms per year 5600 equipment Breast radiographers Mammography Stereotactic Biopsy (Mammography Screening program Ultrasound guided) Verification for Magnetic Resonance Imaging (MRI) Core Biopsy (Tru-cut)

non-palpable breast lesions Galattography Vacuum assisted biopsy on specimen Available work-up imaging Ultrasound-guided biopsy Axillary US/US-guided equipment Fine-needle aspiration biopsy FNAB (FNAB, cytology) Computer Tomography Clinical Research Core Biopsy Ultrasound Vacuum assisted biopsy Magnetic Resonance Imaging (MRI) MRI-guided biopsy PET/CT scan Core Biopsy total body bone scintigraphy Vacuum assisted biopsy Primary technique for localizing non-palpable lesions

Hook-wire (or needle localization)

Charcoal marking/tattooing

ROLL: radio-guided occult lesion localization

Breast Surgery

New operated cases per year (benign and malignant) 348 Primary technique for staging the axilla Dedicated Breast Surgeons 3 Axillary lymph node dissection Surgeons with more than 50 surgeries per year 2 Breast Surgery beds 4 Sentinel lymph node biopsy: Blue dye technique Breast Nurse specialists 1 Outpatient surgery Radio-tracer technique Intra-operative evaluation of sentinel node Blue dye + Radio-tracer Reconstruction performed by Breast Surgeons Axillary sampling Clinical Research

2/6 Garibaldi Hospital Nesima Reconstructive/Plastic Surgery

Reconstructive/Plastic surgeons 1 Type of breast reconstructive surgery available Immediate Reconstruction available Remodelling after breast-conserving surgery

Reconstruction after mastectomy: Two-stage reconstruction (tissue expander followed by implant)

One-stage reconstruction

Autogenous tissue flap Latissimus dorsi flap

Transverse rectus abdominis (TRAM)

Free-flaps (free TRAM, DIEP, SIEA, gluteal, etc.)

Surgery on the contralateral breast for symmetry

Pathology

Dedicated Breast Pathologists 4 Other special studies available Available studies Fluorescence in-situ Hybridization for HER-2 gene (FISH)

Cytology Oncotype Dx (21-gene assay)

Haematoxylin & eosin section (H&E) MammaPrint (70-gene microarray) Surgical specimen Prediction Analysis of Microarray 50-gene set (PAM 50) Sentinel node Parameters included in the final pathology report Core biopsy Pathology stage (pT and pN) Frozen section (FS) Surgical specimen Tumour size (invasive component in mm)

Sentinel node Histologic type Tumor grade Immunohistochemistry stain (IHC) Estrogen receptors ER/PR receptor status

Progesterone receptors HER-2/neu receptor status

HER-2 Peritumoural/Lymphovascular invasion

Ki-67 Margin status

Medical Oncology

Dedicated Breast Medical Oncologists 4 Outpatient systemic therapy Clinical Research

3/6 Garibaldi Hospital Nesima Radiotherapy

Dedicated Radiation Oncologists Available techniques after breast-conserving surgery Clinical Research (including experimental)

Whole-Breast RT (WBRT)

Partial breast irradiation (PBI): External beam PBI

Interstitial brachytherapy

Targeted brachytherapy (MammoSite, SAVI applicator, other devices)

Intra-operative RT (IORT)

Multidisciplinary Meeting (MDM) / Tumour Board (TB)

Regular MDM/TB for case management discussion Specialties/services participating in MDM/TB

Twice a week Radiology

Weekly Breast Surgery

Every two weeks Reconstructive/Plastic Surgery

Other Schedule Pathology

Cases discussed at MDM/TB Medical Oncology Radiotherapy Preoperative cases Genetic Counselling Postoperative cases Breast Nurse Service

Psycho-oncology

Further Services and Facilities

Nuclear Medicine Genetic Counselling

Lymphoscintigraphy Specialist Providing Genetic Counselling/Risk assessment service: Bone scan Dedicated Clinical Geneticist Positron Emission Tomography (PET) Medical Oncologist PET/CT scan Breast Surgeon

Rehabilitation General Surgeon

Prosthesis service Gynaecologist

Physiotherapy Genetic Testing available

Lymph-oedema treatment Surveillance program for high-risk women

Data Management

Database used for clinical information

Data manager available

4/6 Garibaldi Hospital Nesima

Contact details

Clinical Director

Giorgio Giannone, PhyD Director of the Surgical Department [email protected] +390957595935

Radiology

Maria Francesca Rizzo, MD Head of the Department [email protected] +390957595413

Breast Surgery

Fisichella Giacomo, MD Head of the Department [email protected] +390957595516

Reconstructive Surgery

Luca Palumbo, MD Plastic Surgeon [email protected] +390957595515

Pathology

Maria Grazia Galasso, MD Pathologist [email protected] +393929040474

Medical Oncology

Roberto Bordonaro, MD Director of the Oncology Department [email protected] +393401956998

Giuseppe Lavenia, MD Staff Oncologist [email protected] +39 3286564307

Stefania Rapisardi, MD Staff Oncologist [email protected]

Placido Amadio, MD Staff oncologist [email protected] +393296230316

Radiotherapy

Alberto Fausto Rosso, MD Director Of The Radiotherapy [email protected] +390957598051 Department

Salvatore Bonanno, MD Radiotherapist [email protected]

5/6 Garibaldi Hospital Nesima

How to reach us

Garibaldi Hospital Nesima Via Palermo 636 95122 Catania, Phone: +390957591111 Fax: +390957595529 E-mail: [email protected] Web-site: www.ao-garibaldi.catania.it From airport: Bus No. 457 stop in Corso Italia - In Viale XX Settembre, catch bus no. 443 By train: N/A By bus or sub-way/underground: By bus: - From the city centre: 443, 522, 635, 932 - From the Railway Station: 443 - From the airport: 457 (get off in Corso Italia or in Viale XX Settembre and catch bus no. 443) By car: From the centre of Catania: drive up Viale Mario Rapisarda or Corso Indipendenza to get to Piazza Marconi. Then turn right into Via Palermo. From the bypass: in both directions, choose the exit for Misterbianco and take the junction “Circonvallazione Catania”. From the ring road: drive through the ring road up to the roundabout “Monte Po”. Take the exit towards Via Palermo. Last modified: 23 May 2014

6/6