Asklepios Paulinen Klinik Wiesbaden - Wiesbaden, Germany

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- Wiesbaden, Germany General Information New breast cancer cases treated per year 203 Breast multidisciplinarity team members 13 Radiologists, surgeons, pathologists, medical oncologists, radiotherapists and nurses Clinical Director: Volker Heyl, MD Our breast unit has been certified by the German Cancer Society (DKG) and the German Society of Senology (DGS) since 2008. In 2006 we have had the Eusoma initial accreditation. Diagnostic and therapeutic procedures are performed daily under the responsibility of experts in their fields. A interdisciplinary pre- and postoperative tumorconference discusses all patients and give recommendations for further treatments. Furthermore there are several professionals for social care and health consultancy like psycho-oncologists, breast care nurses, social workers, physiotherapist, etc working for or inside our breast unit. We are able to treat more than 40% of all cancer patients in clinical studies. It is worth also mentioning the professional structure of the study centre with its study nurses and study doctors. Asklepios Paulinen Klinik Wiesbaden Geisenheimer Str.10 65197 Wiesbaden, Germany Phone: +496118472390 Fax: +496118472378 E-mail: v.heyl@asklepios.com Web-site: www.asklepios.com/wiesbaden 1/6

Available services Reconstructive/Plastic Surgery Nuclear Medicine Rehabilitation Genetic Counselling Data Management Psycho-oncology Breast Nurses Social Workers Nutritional Counselling Survivorship Groups Sexual Health Counselling Supportive and Palliative Care Integrative Medicine Dedicated Radiologists 2 Mammograms per year 5000 Breast radiographers Screening program Verification for non-palpable breast lesions on specimen Axillary US/US-guided FNAB Available imaging equipment Mammography Ultrasound Magnetic Resonance Imaging (MRI) Available work-up imaging equipment Computer Tomography Ultrasound Magnetic Resonance Imaging (MRI) PET/CT scan Primary technique for localizing non-palpable lesions Hook-wire (or needle localization) Charcoal marking/tattooing ROLL: radio-guided occult lesion localization Available breast tissue sampling equipment Stereotactic Biopsy (Mammography guided) Core Biopsy (Tru-cut) Vacuum assisted biopsy Ultrasound-guided biopsy Fine-needle aspiration biopsy (FNAB, cytology) Core Biopsy Vacuum assisted biopsy MRI-guided biopsy Core Biopsy Vacuum assisted biopsy New operated cases per year (benign and malignant) 205 Dedicated Breast Surgeons 3 Surgeons with more than 50 surgeries per year 3 beds 12 Breast Nurse specialists 2 Outpatient surgery Intra-operative evaluation of sentinel node Reconstruction performed by Breast Surgeons Primary technique for staging the axilla Axillary lymph node dissection Sentinel lymph node biopsy: Blue dye technique Radio-tracer technique Blue dye + Radio-tracer Axillary sampling 2/6

Reconstructive/Plastic Surgery Reconstructive/Plastic surgeons 4 Immediate Reconstruction available Type of breast reconstructive surgery 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 Dedicated Breast Pathologists 1 Available studies Cytology Haematoxylin & eosin section (H&E) Surgical specimen Sentinel node Core biopsy Frozen section (FS) Surgical specimen Sentinel node Immunohistochemistry stain (IHC) Estrogen receptors Progesterone receptors HER-2 Ki-67 Other special studies available Fluorescence in-situ Hybridization for HER-2 gene (FISH) Oncotype Dx (21-gene assay) MammaPrint (70-gene microarray) Prediction Analysis of Microarray 50-gene set (PAM 50) Parameters included in the final pathology report stage (pt and pn) Tumour size (invasive component in mm) Histologic type Tumor grade ER/PR receptor status HER-2/neu receptor status Peritumoural/Lymphovascular invasion Margin status Dedicated Breast Medical Oncologists 3 Outpatient systemic therapy 3/6

Dedicated Radiation Oncologists Available techniques after breast-conserving surgery (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 Twice a week Weekly Every two weeks Other Schedule Cases discussed at MDM/TB Preoperative cases Postoperative cases Specialties/services participating in MDM/TB Reconstructive/Plastic Surgery Genetic Counselling Breast Nurse Service Psycho-oncology Further Services and Facilities Nuclear Medicine Lymphoscintigraphy Bone scan Positron Emission Tomography (PET) PET/CT scan Rehabilitation Prosthesis service Physiotherapy Lymph-oedema treatment Genetic Counselling Specialist Providing Genetic Counselling/Risk assessment service: Dedicated Clinical Geneticist Medical Oncologist Breast Surgeon General Surgeon Gynaecologist Genetic Testing available Surveillance program for high-risk women Data Management Database used for clinical information Data manager available 4/6

Contact details Clinical Director Volker Heyl, MD Head of the Unit v.heyl@asklepios.com +496118472390 Carlo von Bruchhausen Head of Dpt. dr.bruchhausen@diagnostik-wiesbaden.de +496118472464 Volker Heyl Head Physician v.heyl@asklepios.com +496118472390 Margret Wiesmann, MD Specialist Doctor m.wiesmann@asklepios.com +496118472394 Walter Müller, MD Specialist Doctor w.mueller@asklepios.com +496118472372 Reconstructive Surgery Volker Heyl Head of Recostructive Surgery Dpt. v.heyl@asklepios.com +496118472391 Margret Wiesmann, MD Specialist Doctor m.wiesmann@asklepios.com +496118472394 Alberto Peek, MD Specialist Doctor info@plastische-chirurgie-ffm.de +4969598005 Annette Fissler-Eckhoff Head of Dpt. praxis@pathologie-wiesbaden.de +49611404218 Wilfried Esinger, MD Head Physician info@pathologie-darmstadt.de +49615179050 Dr.Klaus Tischbirek Head of Dpt. k.tischbirek@asklepios.com +496118472330 Christina Moisidis-Tesch, MD Specialist Doctor of Medical c.moisidis@asklepios.com +496118472081 Oncology Maryam Hamid-Werner, MD Specialist Doctor m.hamid@askklepios.com +496118472081 Franz Josef Prott Head of Dpt. prott@strahlentherapie-wiesbaden.de +496111771625 Ute Metzmann, MD Specialist Doctor info@stahlentherapiepraxis-mainz.de +496131619980 5/6

How to reach us Asklepios Paulinen Klinik Wiesbaden Geisenheimer Str.10 65197 Wiesbaden, Germany Phone: +496118472390 Fax: +496118472378 E-mail: v.heyl@asklepios.com Web-site: www.asklepios.com/wiesbaden From airport: http://www.asklepios.com/klinik/ By train: http://www.asklepios.com/klinik/ By bus or sub-way/underground: http://www.asklepios.com/klinik/ By car: http://www.asklepios.com/ Last modified: 21 June 2010 6/6