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F. Hached University Teaching Hospital

Sousse, Tunisia

available Social Workers

not available Nutritional Counselling

not available Survivorship Groups

available Sexual Health Counselling

available Supportive and Palliative Care

not available Integrative Medicine

Radiology

availableDedicated Radiologists2

Mammograms per year1200

availableBreast radiographers

not availableScreening program

availableVerification for non-palpable breast lesions on specimen

not availableAxillary US/US-guided FNAB

availableClinical Research

Available imaging equipment

  • availableMammography
  • availableUltrasound
  • availableMagnetic Resonance Imaging (MRI)

Available work-up imaging equipment

  • availableComputer Tomography
  • availableUltrasound
  • availableMagnetic Resonance Imaging (MRI)
  • not availablePET/CT scan

Primary technique for localizing non-palpable lesions

  • availableHook-wire (or needle localization)
  • not availableCharcoal marking/tattooing
  • not availableROLL: radio-guided occult lesion localization

Available breast tissue sampling equipment

  • availableStereotactic Biopsy (Mammography guided)
    • availableCore Biopsy (Tru-cut)
    • not availableVacuum assisted biopsy
  • availableUltrasound-guided biopsy
    • availableFine-needle aspiration biopsy (FNAB, cytology)
    • availableCore Biopsy
    • not availableVacuum assisted biopsy
  • not availableMRI-guided biopsy
    • not availableCore Biopsy
    • not availableVacuum assisted biopsy

Breast Surgery

availableNew operated cases per year (benign and malignant)  450

availableDedicated Breast Surgeons  4

availableSurgeons with more than 50 surgeries per year  3

availableBreast Surgery beds  6

availableBreast Nurse specialists  2

availableOutpatient surgery

availableIntra-operative evaluation of sentinel node

not availableReconstruction performed by Breast Surgeons

availableClinical Research

Primary technique for staging the axilla

  • not availableAxillary lymph node dissection
  • not availableSentinel lymph node biopsy:
    • not availableBlue dye technique
    • not availableRadio-tracer technique
    • not availableBlue dye + Radio-tracer
    • availableIndocyanine Green ( Fluorescence) and blue dye
  • not availableAxillary sampling

Reconstructive/Plastic Surgery

availableReconstructive/Plastic surgeons  2

availableImmediate Reconstruction available

Type of breast reconstructive surgery available

  • not availableRemodelling after breast-conserving surgery
  • availableReconstruction after mastectomy:
    • not availableTwo-stage reconstruction (tissue expander followed by implant)
    • availableOne-stage reconstruction
    • not availableAutogenous tissue flap
      • not availableLatissimus dorsi flap
      • not availableTransverse rectus abdominis (TRAM)
      • not availableFree-flaps (free TRAM, DIEP, SIEA, gluteal, etc.)
  • availableSurgery on the contralateral breast for symmetry

Pathology

availableDedicated Breast Pathologists  3

Available studies

  • availableCytology
  • availableHaematoxylin & eosin section (H&E)
    • not availableSurgical specimen
    • availableSentinel node
    • not availableCore biopsy
  • availableFrozen section (FS)
    • availableSurgical specimen
    • availableSentinel node
  • availableImmunohistochemistry stain (IHC)
    • availableEstrogen receptors
    • availableProgesterone receptors
    • availableHER-2
    • availableKi-67

Other special studies available

  • availableFluorescence in-situ Hybridization for HER-2 gene (FISH)
  • not availableOncotype Dx (21-gene assay)
  • not availableMammaPrint (70-gene microarray)
  • not availablePrediction Analysis of Microarray 50-gene set (PAM 50)

Parameters included in the final pathology report

  • availablePathology stage (pT and pN)
  • availableTumour size (invasive component in mm)
  • availableHistologic type
  • availableTumor grade
  • availableER/PR receptor status
  • availableHER-2/neu receptor status
  • availablePeritumoural/Lymphovascular invasion
  • availableMargin status
  • availableOverall Metastasis Size in Node

Medical Oncology

availableDedicated Breast Medical Oncologists  3

not availableOutpatient systemic therapy

availableClinical Research

Radiotherapy

availableDedicated Radiation Oncologists

availableClinical Research

Available techniques after breast-conserving surgery (including experimental)

  • availableWhole-Breast RT (WBRT)
  • availablePartial breast irradiation (PBI):
    • availableExternal beam PBI
    • not availableInterstitial brachytherapy
    • not availableTargeted brachytherapy (MammoSite, SAVI applicator, other devices)
    • not availableIntra-operative RT (IORT)

Multidisciplinary Meeting (MDM) / Tumour Board (TB)

Regular MDM/TB for case management discussion

  • not availableTwice a week
  • availableWeekly
  • not availableEvery two weeks
  • not availableOther Schedule

Cases discussed at MDM/TB

  • available Preoperative cases
  • available Postoperative cases

Specialties/services participating in MDM/TB

  • availableRadiology
  • availableBreast Surgery
  • not availableReconstructive/Plastic Surgery
  • availablePathology
  • availableMedical Oncology
  • availableRadiotherapy
  • not availableGenetic Counselling
  • availableBreast Nurse Service
  • not availablePsycho-oncology

Further Services and Facilities

Nuclear Medicine

  • not availableLymphoscintigraphy
  • availableBone scan
  • not availablePositron Emission Tomography (PET)
  • not availablePET/CT scan

Rehabilitation

  • not availableProsthesis service
  • availablePhysiotherapy
  • availableLymph-oedema treatment

Genetic Counselling

  • availableSpecialist Providing Genetic Counselling/Risk assessment service:
    • availableDedicated Clinical Geneticist
    • not availableMedical Oncologist
    • not availableBreast Surgeon
    • not availableGeneral Surgeon
    • not availableGynaecologist
  • availableGenetic Testing available
  • not availableSurveillance program for high-risk women

Data Management

  • availableDatabase used for clinical information
  • not availableData manager available

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