14
Cooper Cancer Institute 2011 Statistical Annual Report
Cooper Cancer Institute2011 Statistical Annual Report
Dear Friend,
For most of us, the close of a year is a time of reflection – of looking back on ouraccomplishments, and perhaps, recognizing where we could have done more. It is also atime to set goals for the year ahead – to enter the New Year with a renewed sense of spirit,of re-dedication to our purpose, and a commitment to finding and creating newopportunities.
As this report will demonstrate, this past year has been one filled with many achievements,but for many people throughout Cooper Cancer Institute (CCI), 2012 can be characterizedas a year of planning – bringing to reality our vision and hope for the future. Teams ofphysicians, nurses, and other clinical and administrative staff have worked tirelesslythroughout the past year planning for the opening of the new Cooper Cancer Institute inCamden and the renovation and expansion of our cancer services at Cooper – Voorhees.And the work continues.
Throughout this process, the two questions we ask along every point in the decision-making process are:
• What is best for our patients?• Is there a better way to do this?
With these questions as our guide, we incorporate “best practices” in cancer care into the design of the physical environment, the acquisition of new diagnostic and treatmenttechnologies, and the development of our operational structure – taking the steps to learn,adapt, and lead the way into the future.
Innovative thinking, counsel from the best of the best, community engagement, and asingular focus on providing the best possible cancer care to our patients – it’s what we havealways done and what we will continue to do.
With another remarkable year behind us, the coming year holds even greater possibilities.
Sincerely,
Generosa Grana, MDDirector, Cooper Cancer InstituteHead, Division of Hematology/Medical OncologyCooper University Hospital
If you don't know where you are going, you'll end up someplace else.
YOGI BERRA
1
Cooper University Hospital’s Cancer Registrysupports the activities of the Cancer Committee
and Cooper Cancer Institute.The Registry staff oversees the collection, quality
assurance, lifetime follow-up and analysis of datafrom patients diagnosed with cancer who receiveall or part of their care at Cooper and those othersdeemed reportable. The Cancer Registry workingdatabase has 18,847 cases since 2001 with a success- ful follow-up rate of 94%.Cancer centers report specifics of diagnosis,
stage of disease, medical history, patient demo-graphics, laboratory data, tissue diagnosis, andmedical, radiation, and surgical methods of treat-ment for each cancer diagnosed at their facility. Thedata is used to observe cancer trends and provide aresearch base for studies into the possible causes ofcancer with the goal of reducing cancer incidenceand death.
Registry data also serves as an ongoing resourceto the Cancer Committee in determining the mosteffective allocation of resources, in determiningcommunity education and outreach initiatives and in monitoring program quality.The Registry provides vital statistics and informa-
tion to clinicians and researchers as well as local, stateand national cancer databases and cancer-relatedorganizations. This contribution of informationadvances the body of knowledge in the field ofcancer and ultimately has a positive impact oncancer patient care.For Cooper’s data to be comparable to those
collected at other programs around the country, theregistrars adhere to data rules established by thecollecting and credentialing organizations. Keepingup with these changes can be challenging, but CooperCancer Registrars understand the significance oftheir work and are experts in their field.
2
Mandatory Members
Generosa Grana, MDChair, Cancer CommitteeHead, Division ofHematology/Medical Oncology, Director, Cooper Cancer Institute
Umar Atabek, MDHead, Division of SurgicalOncologyCancer Liaison
Raymond Baraldi, MDChief, Department of Radiology
Kristen Brill, MDHead, Division of Breast SurgeryDirector, The Janet Knowles BreastCancer Center
Diane Bush, CTRManager, Cancer Registry Department
Dana Clark, MS, MSCancer Genetics Counselor
Kim Krieger, BA, CCRPActing Manager, Clinical ResearchOffice, Division of Hematology/Medical Oncology
Cooper University Hospital Cancer Committee*
Lisa McLaughlin, MSW, LSW, OSW-CSocial Worker, CCI
Tamara LaCouture, MDChief, Department of RadiationOncology
Ann Steffney, MSN, RN, OCNBreast Cancer Nurse Navigator, CCIActing Administrative Designee
Carol Stratton, MSPT, ATC, CLTDirector, Physical RehabilitationServices
Evelyn Robles-Rodriguez, RN, MSN, APN-C, AOCNOncology Advanced Practice NurseDirector, Oncology OutreachPrograms
Roland Schwarting, MDChief, Department of Pathology and Laboratory Medicine
Barbara Sproge, MSN, RN, OCNClinical Educator, Palliative CareProgram
Other Attendees
Jaime Austino, MSN, RN, OCNGenitourinary Cancer NurseNavigator, CCI
Linda Goldsmith, RD, CSOOutpatient Cancer Nutritionist,Food and Nutrition Services
Dianne Hyman, MSN, RN, OCNCamden Nurse Navigator, CCI
Frank Koniges, MDAttending Physician, Department of Surgery
Robert LumpeChaplain, Pastoral Care
Susan Maltman, MSN, RN, OCNClinical Manager, Division ofGynecologic Oncology
Alicia Michaux, MSRDOutpatient Cancer Nutritionist,Food and Nutrition Services
Alice O’Brien, RN, OCN,HP(ASCP)Leukemia/Lymphoma NurseNavigator, CCI
Cori McMahon, PsyDDirector of Behavioral Medicine,Division of Hematology/MedicalOncology
Leslie Tarr, MSW, OSW-CSocial Worker, CCI
Jackie Tubens, RN, MSNGI Nurse Navigator, CCI
Charu Vora, RN, BSN, OCN, MSW, BSLung Cancer Nurse Navigator, CCI
David Warshal, MDHead, Division of GynecologicOncology
*Committee members at time of publication.
Cancer Registry Department Staff
Diane Bush, CTR, ManagerJacqueline Ellis-Riffle, CTR, Cancer Registrar
Annette Harley, CTR, Cancer Registrar
Cancer Registry Report
Brian Palidar, RHIT, CTR, Cancer RegistrarKaren Staller, RHIT, Cancer Registrar
3
Top Five Cancer Sites (M/F Combined) PERCENT OF TOTAL ANALYTIC CASES 2001-2011
CCI Patient’s County of Residence at Diagnosis PERCENT OF TOTAL ANALYTIC CASES 2011
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Breast 19.8 20.7 26.8 25.6 22.0 21.7 22.0 23.8 21.3 22.9 22.5
Lung 10.6 10.2 9.9 10.4 11.7 10.9 11.9 9.9 10.9 10.5 11
Corpus Uterus 10.3 10.8 11.8 11.9 9.5 10.4 10.7 8.0 9.3 9.3 10.6
Colon/Rectum 8.9 8.9 10.1 8.5 8.3 8.0 9.0 7.1 8.6 7.4 7.4
Prostate 9.3 10.2 8.8 11.8 9.8 10.4 9.2 7.0 4.8 5.4 6.6
TOTAL 58.9 60.8 67.4 68.2 61.3 61.4 62.8 55.8 54.9 55.5 58.1
Atlantic . . . . . . . . . .5%
Cumberland . . . . . .4%
Outside State . . . . . .3%
Cape May . . . . . . . .2%
Salem . . . . . . . . . . .2%
Mercer . . . . . . . . . . .2%
Ocean . . . . . . . . . . .2%
Other/Unknown . . .2%
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0
Prostate
Colon/Rectum
Corpus Uterus
Lung
Breast
2011
COUNTY AT % DIAGNOSIS of CASES
Camden 44.57%
Burlington 19.68%
Gloucester 13.55%
Atlantic 5.26%
Cumberland 3.74%
Outside State 3.16%
Cape May 2.39%
Salem 2.39%
Mercer 2.22%
Ocean 2.22%
Other/Unknown 0.82%
TOTAL 100%
{OTHER21%
CAMDEN45%
BURLINGTON20%
GLOUCESTER14%
C A N C E R R E G I S T R Y R E P O R T
4
Summary by Body System, Sex, Class, Status and Best CS/AJCC Stage Report2011 ANALYTIC COMPLETE
C A N C E R R E G I S T R Y R E P O R T
Primary Site
ORAL CAVITY & PHARYNXTongue
Salivary Glands
Floor of Mouth
Gum & Other Mouth
Nasopharynx
Tonsil
Oropharynx
Hypopharynx
DIGESTIVE SYSTEMEsophagus
Stomach
Small Intestine
Colon Excluding Rectum
Cecum
Appendix
Ascending Colon
Hepatic Flexure
Transverse Colon
Splenic Flexure
Descending Colon
Sigmoid Colon
Large Intestine, NOS
Rectum & Rectosigmoid
Rectosigmoid Junction
Rectum
Anus, Anal Canal & Anorectum
Liver & Intrahepatic Bile Duct
Liver
Intrahepatic Bile Duct
Gallbladder
Other Biliary
Pancreas
Retroperitoneum
Peritoneum, Omentum & Mesentery
Other Digestive Organs
RESPIRATORY SYSTEMNose, Nasal Cavity & Middle Ear
Larynx
Lung & Bronchus
BONES & JOINTSBones & Joints
SOFT TISSUESoft Tissue (including Heart)
SKIN Excluding Basal & SquamousMelanoma – Skin
Other Non-Epithelial Skin
BREASTBreast
Total (%)
32 (1.9%)8 (0.5%)
2 (0.1%)
2 (0.1%)
5 (0.3%)
3 (0.2%)
7 (0.4%)
2 (0.1%)
3 (0.2%)
300 (17.5%)23 (1.3%)
26 (1.5%)
6 (0.4%)
93 (5.4%)
16
5
14
11
8
1
6
25
7
35 (2.0%)
11
24
3 (0.2%)
21 (1.2%)
18
3
3 (0.2%)
21 (1.2%)
56 (3.3%)
5 (0.3%)
6 (0.4%)
2 (0.1%)
194 (11.3%)2 (0.1%)
4 (0.2%)
188 (11.0%)
1 (0.1%)1 (0.1%)
11 (0.6%)11 (0.6%)
40 (2.3%)37 (2.2%)
3 (0.2%)
385 (22.5%)385 (22.5%)
Male
196
0
1
4
1
4
1
2
14918
14
5
34
2
2
7
6
4
0
2
10
1
24
8
16
2
15
14
1
0
14
21
1
0
1
902
4
84
11
88
2725
2
00
Female
132
2
1
1
2
3
1
1
1515
12
1
59
14
3
7
5
4
1
4
15
6
11
3
8
1
6
4
2
3
7
35
4
6
1
1040
0
104
00
33
1312
1
385385
Analy
328
2
2
5
3
7
2
3
30023
26
6
93
16
5
14
11
8
1
6
25
7
35
11
24
3
21
18
3
3
21
56
5
6
2
1942
4
188
11
1111
4037
3
385385
Class of CaseSex
NA
00
0
0
0
0
0
0
0
00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
00
0
0
00
00
00
0
00
Alive
265
2
1
4
3
7
1
3
22712
19
3
88
15
5
14
9
8
1
6
23
7
31
10
21
3
11
10
1
3
14
31
4
6
2
1302
3
125
11
1010
3936
3
363363
Status
Exp
63
0
1
1
0
0
1
0
7311
7
3
5
1
0
0
2
0
0
0
2
0
4
1
3
0
10
8
2
0
7
25
1
0
0
640
1
63
00
11
11
0
2222
Stage 0
00
0
0
0
0
0
0
0
111
0
0
5
1
0
1
0
0
0
0
2
1
2
1
1
1
0
0
0
0
0
2
0
0
0
20
1
1
00
00
99
0
9393
Stage I
31
0
0
1
0
1
0
0
601
4
0
30
2
1
4
5
3
1
3
11
0
7
3
4
1
8
7
1
1
3
3
2
0
0
550
2
53
11
44
1818
0
166166
Stage II
41
0
2
1
0
0
0
0
629
6
0
16
6
1
1
1
2
0
0
4
1
6
2
4
0
1
1
0
1
5
16
2
0
0
130
0
13
00
22
66
0
6464
Stage III
70
0
0
1
2
1
1
2
636
3
3
21
3
0
5
2
3
0
0
5
3
10
2
8
0
1
1
0
0
4
9
1
5
0
450
0
45
00
22
42
2
2828
Stage IV
134
1
0
1
0
5
1
1
645
8
2
17
3
3
2
3
0
0
2
2
2
6
2
4
0
3
2
1
1
4
18
0
0
0
661
1
64
00
22
21
1
2121
88
00
0
0
0
0
0
0
0
70
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
1
0
2
0
0
1
2
10
0
1
00
11
00
0
11
Unk
52
1
0
1
1
0
0
0
331
5
1
4
1
0
1
0
0
0
1
1
0
4
1
3
1
6
6
0
0
3
8
0
0
0
121
0
11
00
00
11
0
1212
Stage Distribution – Analytic Cases Only
5
Summary by Body System, Sex, Class, Status and Best CS/AJCC Stage Report2011 ANALYTIC COMPLETE (continued)
C A N C E R R E G I S T R Y R E P O R T
Primary Site
FEMALE GENITAL SYSTEMCervix Uteri
Corpus & Uterus, NOS
Corpus Uteri
Uterus, NOS
Ovary
Vagina
Vulva
Other Female Genital Organs
MALE GENITAL SYSTEMProstate
Testis
Penis
Other Male Genital Organs
URINARY SYSTEMUrinary Bladder
Kidney & Renal Pelvis
Ureter
BRAIN & OTHER NERVOUS SYSTEMBrain
Cranial Nerves Other Nervous System
ENDOCRINE SYSTEMThyroid
Other Endocrine including Thymus
LYMPHOMAHodgkin Lymphoma
Non-Hodgkin Lymphoma
NHL – Nodal
NHL – Extranodal
MYELOMAMyeloma
LEUKEMIALymphocytic Leukemia
Acute Lymphocytic Leukemia
Chronic Lymphocytic Leukemia
Other Lymphocytic Leukemia
Myeloid & Monocytic Leukemia
Acute Myeloid Leukemia
Acute Monocytic Leukemia
Chronic Myeloid Leukemia
Other Leukemia
MESOTHELIOMAMesothelioma
KAPOSI SARCOMAKaposi Sarcoma
MISCELLANEOUSMiscellaneous
Total
Total (%)
302 (17.6%)45 (2.6%)
182 (10.6%)
173
9
51 (3.0%)
3 (0.2%)
20 (1.2%)
1 (0.1%)
129 (7.5%)113 (6.6%)
14 (0.8%)
1 (0.1%)
1 (0.1%)
60 (3.5%)25 (1.5%)
34 (2.0%)
1 (0.1%)
49 (2.9%)24 (1.4%)
25 (1.5%)
79 (4.6%)70 (4.1%)
9 (0.5%)
53 (3.1%)10 (0.6%)
43 (2.5%)
30
13
14 (0.8%)14 (0.8%)
34 (2.0%)10 (0.6%)
2
6
2
23 (1.3%)
18
2
3
1 (0.1%)
2 (0.1%)2 (0.1%)
1 (0.1%)1 (0.1%)
26 (1.5%)26 (1.5%)
1,712
Male
00
0
0
0
0
0
0
0
129113
14
1
1
4120
21
0
2616
10
1410
4
305
25
15
10
55
175
0
3
2
11
9
1
1
1
22
11
1616
575
Female
30245
182
173
9
51
3
20
1
00
0
0
0
195
13
1
238
15
6560
5
235
18
15
3
99
175
2
3
0
12
9
1
2
0
00
00
1010
1,137
Analy
30245
182
173
9
51
3
20
1
129113
14
1
1
6025
34
1
4924
25
7970
9
5310
43
30
13
1414
3410
2
6
2
23
18
2
3
1
22
11
2626
1,712
Class of CaseSex
NA
00
0
0
0
0
0
0
0
00
0
0
0
00
0
0
00
0
00
0
00
0
0
0
00
00
0
0
0
0
0
0
0
0
00
00
00
0
Alive
26939
166
160
6
40
3
20
1
125109
14
1
1
4817
30
1
4221
21
7869
9
449
35
24
11
1010
228
1
6
1
13
11
0
2
1
11
11
1414
1,450
Status
Exp
336
16
13
3
11
0
0
0
44
0
0
0
128
4
0
73
4
11
0
91
8
6
2
44
122
1
0
1
10
7
2
1
0
11
00
1212
262
Stage 0
50
1
1
0
0
0
4
0
00
0
0
0
55
0
0
00
0
00
0
00
0
0
0
00
00
0
0
0
0
0
0
0
0
00
00
00
125
Stage I
17622
126
125
1
15
0
12
1
3223
8
1
0
245
19
0
00
0
4646
0
101
9
5
4
00
00
0
0
0
0
0
0
0
0
00
00
00
595
Stage II
294
17
15
2
5
2
1
0
7570
5
0
0
87
0
1
00
0
33
0
84
4
2
2
00
00
0
0
0
0
0
0
0
0
00
00
00
274
Stage III
5110
16
16
0
21
1
3
0
87
1
0
0
113
8
0
00
0
99
0
50
5
4
1
00
00
0
0
0
0
0
0
0
0
00
00
00
233
Stage IV
236
12
8
4
5
0
0
0
109
0
0
1
73
4
0
00
0
66
0
152
13
9
4
00
00
0
0
0
0
0
0
0
0
11
00
00
230
88
52
3
3
0
0
0
0
0
00
0
0
0
00
0
0
4924
25
90
9
00
0
0
0
1414
3410
2
6
2
23
18
2
3
1
11
11
2626
149
Unk
131
7
5
2
5
0
0
0
44
0
0
0
52
3
0
00
0
66
0
153
12
10
2
00
00
0
0
0
0
0
0
0
0
00
00
00
106
Stage Distribution – Analytic Cases Only
6
Performance for NQF Breast Care Measures
National Standard for Breast Conserving Surgery and Radiation TherapyRadiation therapy is administered within one year (365 days) ofdiagnosis for women under the age of 70 receiving breast conservingsurgery for breast cancer. Cooper Cancer Institute’s compliance withthis standard was very favorable at 94.2%, compared to the state normof 82.9% and the national norm of 87.4%.
National Standard for Chemotherapy in hormone receptor negative breast cancer patients.Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for women under 70 with AJCCT1cN0M0, or Stage II or III hormone receptor negative breast cancer.Cooper Cancer Institute’s compliance with this standard was veryfavorable at 100%, compared to the state norm of 84.5% and nationalnorm of 89.5%.
Measuring Quality
94.2%
82.9%87.4%
CCI NJ US
100%
84.5%89.5%
CCI NJ US
How do patients know if theyare receiving good qualityhealthcare?
How do physicians andnurses identify the steps thatneed to be taken for betterpatient outcomes?
And how do insurers andemployers determine whetherthey are paying for the bestcare that science, skill, andcompassion can provide?
Performance measuresPerformance measures give the healthcare community a way to assessquality of care provided against recognized standards. While qualitymeasures come from many sources, those endorsed by the NationalQuality Forum (NQF) have become established as among the best. An NQF endorsement reflects rigorous scientific and evidence-basedreview, input from patients and their families, and the perspectives of people throughout the healthcare industry.
One of the ways Cooper Cancer Institute assesses the quality of thecare we give to our cancer patients is to compare our performance inNQF standards to those of other hospitals in New Jersey and theUnited States.
National Quality Forum has established six measures for quality carein breast, and colon and rectal cancer. Below you will find how CooperCancer Institute compares to other hospitals in New Jersey and acrossthe U.S. in these critical performance measures.
Cooper Cancer Institute data surpasses all bench marks — local, state,regional and national.
7
National Standard for Tamoxifen or third generation aromataseinhibitor in hormone receptor positive breast cancer patients.Tamoxifen or third generation aromatase inhibitor is considered oradministered within one year (365 days) of diagnosis for women withAJCC T1cN0M0, or Stage I hormone receptor positive breast cancer.Cooper Cancer Institute’s compliance with this standard was veryfavorable at 99%, compared to the state norm of 78.3% and thenational norm of 82.2%.
99%
78.3%82.2%
CCI NJ US
Performance for Colon and Rectal Cancer NQF Measures
National Standard for Regional Lymph Nodes in Surgically Resected PatientsAt least 12 regional lymph nodes are removed and pathologicallyexamined for resected colon cancer. The compliance rate for CooperCancer Institute was very favorable at 93.9%, compared to the statenorm of 85.3% and the national norm of 86.4%.
National Standard for Adjuvant Chemotherapy for Node Positive PatientsAdjuvant chemotherapy is considered or administered within 4 months (120 days) of diagnosis for patients under the age of 80 with AJCC stage III (lymph node positive) colon cancer. Thecompliance rate for Cooper Cancer Institute was very favorable at 91.7% compared to the state norm of 85.4% and the national norm of 88.8%
National Standard for Radiation Therapy of Stage III Rectal CancerRadiation therapy is considered or administered within 6 months (180 days) of diagnosis for patients under the age of 80 with clinical orpathologic AJCC T4N0Mo or Stage III receiving surgical resection forrectal cancer. The compliance rate for Cooper Cancer Institute wasvery favorable at 100%, compared to the state norm of 88.6% and thenational norm of 90.4%.
93.9%
85.3% 86.4%
CCI NJ US
91.7%85.4% 88.8%
1
CCI NJ US
100%
88.6% 90.4%
CCI NJ US
8
EpidemiologyBreast cancer prevails as the most common cancer among
women, and remains the second leading cause of cancer death inwomen. It is estimated that 226,870 women will be diagnosed withbreast cancer in 2012, and 39,510 women will die of the disease.The overall lifetime risk of developing breast cancer can be expressed as about one in eight women, with an average age of 61 years. The breast cancer incidence rate began to decline in 2000after peaking at 142 per 100,000 women in 1999. The dramatic decrease of almost 7% from 2002 to 2003 has been attributed to reductions in the use of hormone replacement therapy. However,from 2004-2008, the most recent five years for which data areavailable, breast cancer incidence rates were stable.
Besides being female, increasing age is the most important riskfactor for breast cancer. Potentially modifiable risk factors includeobesity, use of hormone replacement therapy, physical inactivity,and excessive alcohol consumption. It is well recognized that ahistory of atypical cells or LCIS on biopsy or exposure to high-dose radiation to the chest also increases risk of developing breast cancer.
Risk is also increased by a family history of one or more first-degree relatives with breast cancer (though most women withbreast cancer do not have a family history of the disease). Inheritedmutations in breast cancer susceptibility genes, referred to as BRCA1and BRCA2 mutations account for approximately 5%-10% of allfemale and male breast cancer cases, but are very rare in the generalpopulation (much less than 1%).
DemographicsTumor Registry data at Cooper University Hospital from 2011
indicates that 385 individuals received a portion or all of theirbreast cancer care at Cooper University Hospital. Data from 2003-2005 compared to 2011 shows the counties served have remained
C O O P E R C A N C E R I N S T I T U T E
Breast Cancer Report
A N N U A L R E P O R T 2 0 1 1
Kristin L. Brill, MD, FACSDirector, The Janet Knowles Breast Cancer CenterDirector, Section of Breast Surgery
Camden: 51.9%
Cumberland: 1.9%
Gloucester: 18.74%
All Other: 6.1%
Atlantic: 3.34%
Burlington: 18.02%
2003—2005 Analytic Breast by County
Camden: 47.01%
Cumberland: 1.82%
Gloucester: 18.7%
All Other: 7.01%
Atlantic: 4.94%
Burlington: 20.52%
2011 Analytic Breast by County
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stable, with nearly half of treated individuals origi-nating from Camden County. Other regions servedinclude Burlington and Gloucester counties.
While the average age of diagnosis of breastcancer is 61, the average age at diagnosis at Cooperis in the 5th decade, with 28% of those treated atCooper diagnosed under the age of 50. This com-pares to the National Cancer Data Base (NCDB) datafrom 2010 showing only 4% of the newly diagnosedcases occurred in those under the age of 50. Thismight be explained by the combined efforts in community outreach and education, high risk
assessment, as well as a dedicated breast imagingteam with a variety of current breast imaging technologies.
Stage at diagnosis at Cooper compares to nationaldata, with the majority of breast cancer patients beingdiagnosed as early as Stage 0, Stage 1 or Stage 2cancers. Breast cancer survival correlates stronglywith stage at diagnosis, so that early stage breastcancer has significantly better survival rates.
When Cooper University Hospital survival data iscompared to national survival data from the NationalCancer Data Base, 5-year survival rates are nearly
Age at Diagnosisfor Breast Cases at Cooper University HealthCare vs. NCDB, National Cancer Data Base (2010 most current year availiable)
AJCC Stage at Diagnosisfor Breast Cases at Cooper University HealthCare vs. NCDB, National Cancer Data Base (2010 most current year availiable)
0 1 1A 1B 2 2A 2B 3 3A 3B 3C 4 Unk
Stage
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
Percentag
e
CUH 2011
CUH 2000–2010
NCDB 2010
NCDB 2000–2010
0–29 30–39 40–49 50–50 60–69 70–79 80–89 90+ Unknown
Age at Diagnosis
30%
25%
20%
15%
10%
5%
0%
Percentag
e
CUH 2011
CUH 2000–2010
NCDB 2010
NCDB 2000–2010
2000-2010 Breast Cancer Treatment Total Cases
2011 Analytic Breast TreatmentTotal Cases
Other
Surgery/Hormone/Radiation/Chemo
Surgery/Hormone/Radiation
Surgery/Hormone/Chemo
Surgery/Hormone
Surgery/Chemo/Radiation
Surgery/Radiation
Surgery/Chemo
Surgery
Chemo
Other
Surgery/Hormone/Radiation/Chemo
Surgery/Hormone/Radiation
Surgery/Hormone/Chemo
Surgery/Hormone
Surgery/Chemo/Radiation
Surgery/Radiation
Surgery/Chemo
Surgery
Chemo
0 200 400 600
Number of Cases0 20 40 60 80 100
Number of Cases
10
identical for the lower Stage 0 to Stage 2 breast cancer patient. However, Cooper observes slightlyhigher 5-year survival rates in Stage 3 and Stage 4patients.
The different treatment patterns of surgery,chemotherapy, hormonal therapy and radiation reflect the multimodality approach and tailoredtreatment plans created by collaborative efforts atthe Janet Knowles Breast Center. Treatment patternschange over time with advancements in technologyand practice changing information. The data indicates
that from 2000 to 2010, about 42% of patients wereoffered chemotherapy as part of their treatment. In 2011, only 27% of individuals had chemotherapyincorporated as part of their treatment. This is likelydue to innovations in identifying tumor potentialand risk through genomic profiling that allows clinicians to better identify those patients whomight benefit from chemotherapy. Similar trendscan be observed as more treatment options areavailable with respect to radiation, surgery and reconstructive surgery.
Five Year Survival Rate2003-2005 Analytic Breast Cancer Cases by AJCC StagingCooper University HealthCare vs. National Cancer Data Base
Stage 1 Stage 2 Stage 3 Stage 4 Stage 5
96.4 92.1 86.1 73.3 30.8
95.6 92.1 85.3 66.1 20.9
120%
100%
80%
60%
40%
20%
0%
Percentag
e
Cooper
NCDB
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Comprehensive Care at the JanetKnowles Breast Cancer Center
This year, the Janet Knowles Breast Cancer Centerwas awarded NAPBC (National Accreditation Pro-gram of Breast Centers) accreditation. This statusrecognizes the program as a multidisciplinary, inte-grated and comprehensive breast program, dedicatedto the improvement of quality of care and outcomesof women with breast disease. This multidisciplinaryteam of experts consists of:• Breast Radiologists• Medical Oncologists• Breast Surgeons• Radiation Oncologists• Plastic and Reconstruction Surgeons• Pathologists• Medical Geneticists• Nurse Practitioners• Nurse Navigators• Social Workers
The group meets regularly to review cases anddiscuss and determine optimal treatment options.
Education, Outreach, ScreeningIn concordance with the spirit of the Cooper
mission, the Outreach Screening Project providesscreening services, education, and access to care fornewly diagnosed cancers. The screening projectprovided more than 1800 screening mammogramsin 2011 with the identification of 22 new cancers,treated at Cooper.
The Breast Imaging Center at Cooper UniversityHospital consists of a team of fellowship trained,dedicated breast imagers and staff who provide avariety of imaging and biopsy techniques, currentlyat three sites in our region. They offer digital mam-mography, breast MRI, high resolution ultrasoundand contrast enhanced mammography. The standardof care for breast cancer diagnosis has moved towardimage guided biopsy and diagnosis and away fromsurgical biopsy for diagnosis. To this end, theyperform vacuum-assisted core biopsy under mammogram, ultrasound or MRI.
More recently, Cooper has committed significant
resources to the development of the breast recon-struction program with the addition of two fellow-ship trained microvascular plastic surgeons for a total of five plastic surgeons who offer an array ofreconstructive options. Members of the team aretrained to perform tissue transfer techniques allow-ing more sophisticated, and realistic results. Workingclosely with the breast surgeons to determine surgicaloptions, a woman may be offered options that rangefrom breast conservation with a lumpectomy, topossibly a skin or nipple sparing mastectomy involving the immediate reconstruction of thebreast shape.
Radiation Oncology continues its commitment toincorporating innovative technologies into its arsenalof treatment options including IMRT, Cyber Knifeand most recently, partial breast radiation. As an alternative to the standard whole breast radiation, a patient may now be offered a shorter course ofbreast radiation using a radiation delivery deviceinserted into the lumpectomy cavity. In 2012, theJanet Knowles Breast Center was deemed a Center ofExcellence for this partial breast radiation technique,acknowledging the institution as having the mostexperience with this technique in the region.
Cooper Cancer Institute is at the forefront ofclinical research by offering a variety of clinical trialsto eligible patients. Patients have access to NCI-sponsored national trials, as well as pharmaceutical-sponsored trials.
The Cancer Genetics Program evaluates andcounsels women who may be high risk, and pro-vides testing that can be used to guide treatmentand prevention.
Our team takes pride in its collaborative approachtoward identifying and educating patients abouttheir particular treatment options, clinical trialsavailable for adjuvant radiation and chemo therapy,and ongoing support through diagnosis, decision-making, treatment and long term surveillance. The Janet Knowles Breast Center has earned thereputation as the region’s leading breast center for expertise, cutting edge technologies and compassionate care.
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New Cooper Cancer Institute – To Open Fall 2013
Progress continues on the construction of the new Cooper Cancer Institute inCamden. The four-story, 103,050 square foot building will house all outpatientcancer care services on the Camden campus under one roof.
The new $100 million building will be located adjacent to Three Cooper Plaza onHaddon Avenue – just steps away from the hospital and the new medical school– further developing the footprint and spectrum of services available on theHealth Sciences Campus.
In the new building, physicians from various medical disciplines (e.g. medicaloncology, radiation oncology, surgical oncology, gynecologic oncology, andurology) will conduct concurrent, complementary clinical sessions, fosteringprofessional interaction and collaboration. Patients get the benefit of easy accessto advanced treatment technologies, groundbreaking clinical trials, and a fullrange of supportive care services in one facility.
In addition to the new building, the project includes service enhancements andequipment upgrades at the Cooper – Voorhees facility with the addition of asecond linear accelerator and the installation of a permanent PET/CT.
World Class Care. Right Here. Right Now.
1.800.8.COOPER1.800.826.6737
CooperHealth.org/cancer
George E. Norcross, IIIChairman
Joan S. DavisVice Chairman
John P. Sheridan, Jr.President and CEO
