Karen S. Karsif, M.D., FACS — A New Beginning for Breast Care at 
Good Samaritan Hospital

Successful breast cancer care requires a comprehensive approach to the disease that involves the expertise of multiple physician specialists and advanced diagnostic and treatment technologies, as well as services, such as patient navigation, genetic counseling and support groups. Good Samaritan Hospital in Suffern, NY, is making itself a regional destination for outstanding breast cancer care through the construction — literally and figuratively — of its Center for Breast Health.

Karen S. Karsif, M.D., FACS, Director of the Center for Breast Health and a dedicated breast surgeon, arrived at Good Samaritan Hospital on December 1, 2010, to build the center from the ground up, a task for which she has a wealth of experience. Dr. Karsif performed the same work at her previous facility, New York Hospital Queens, where she developed a breast center that eventually included a high-risk assessment clinic and a focus on community outreach.

“Women are generally well informed about the need for a subspecialist and when the need arises, want to be seen by a dedicated breast surgeon,” Dr. Karsif says. “Good Samaritan Hospital asked me to join the staff because hospital leadership realized they didn’t have such a specialist. I was happy to come to Suffern and help the hospital improve care for women with breast cancer, and the hospital has definitely upheld its end of the bargain by providing me all the support I need.”

Step by Step

One of the first steps in building the Center for Breast Health was finding a home for it. Renovations will begin this month in the medical office building adjoining Good Samaritan Hospital. When the project is complete — in late June or early July — the center will occupy the suite, which will feature its own entrance and waiting room. Nearly everything women need for breast cancer treatment will be housed under one roof, as women’s imaging instrumentation — including digital mammography, MRI and ultrasound — will be available in the new Center for Breast Health. In addition, the first floor of the building will also contain a new outpatient surgery center where Dr. Karsif will perform most of her breast cancer surgeries. The radiation oncology department at Good Samaritan Hospital is currently undergoing renovation. The department features both whole breast radiation and partial breast radiation services using MammoSite 5-Day Targeted Radiation Therapy, a system that allows postoperative patients to receive treatment for five to seven days instead of six weeks.

Advanced Imaging Capabilities

The second step for Dr. Karsif in building the center was taking stock of Good Samaritan Hospital’s women’s imaging capabilities and deciding what needed to be added. Shortly before Dr. Karsif arrived, the hospital purchased a Senographe Essential Digital Mammography system from GE Healthcare, and the hospital plans to purchase a second unit this summer. The new equipment produces images of outstanding clarity and offers the largest field of view available on the market. Aside from benefits common to all digital mammography systems — including enhanced detection capabilities for women younger than 50 and those with dense breast tissue — many patients have told Dr. Karsif they experience less discomfort when receiving a mammogram with the Senographe Essential Digital Mammography system compared to other digital mammography units. A radiology technician at Good Samaritan Hospital improvised an additional way to make the mammography experience more pleasant by using a slightly warmed pad on which to place patients’ breasts during the exam; the practice is now used on all mammograms performed at the hospital.

The most recent addition to the center’s imaging capabilities is MRI, a potent tool in the detection of breast cancer, but one Dr. Karsif feels must not be used indiscriminately.

“Many women want to have an MRI because it’s very sensitive and will detect almost all breast cancers, but it’s also not very specific and will frequently flag things that turn out to be nothing, causing women to endure unnecessary anxiety,” she says. “MRI should be used if an abnormality appears on a mammogram for a woman who has breast implants or dense breast tissue, or if a mammogram or ultrasound reveals something that leaves the physician unsure of what it is. MRI is also a screening tool for people carrying the BRCA1 and BRCA2 genes. I ensure patients of mine who carry those genes undergo an MRI every year.”

Good Samaritan Hospital also recently acquired the LOGIQ E9 ultrasound system by GE Healthcare. The LOGIQ E9’s volume navigation capability allows radiologists to combine the best of all imaging modalities by merging images from previous MRI, computed tomography or ultrasound tests while looking at a real-time image acquired with the LOGIQ E9.

The Center for Breast Health also has the ability to perform needle localization surgery in cases when an abnormality is discovered on a mammogram and a biopsy can be obtained without surgery. Dr. Karsif is pleased to have access to a device that streamlines the process of ensuring whether or not the abnormal tissue is removed: the Bioptics BioVISION specimen radiography system.

“It used to take anywhere from 15 to 45 minutes for a specimen to be taken to a radiologist, who would verify whether or not I got what I was after,” Dr. Karsif says. “With the BioVISION, I simply hand the specimen to a radiology technician, he or she places it in the machine and I learn immediately whether or not I have the sample I need.”

A Caring, Experienced Staff

Dr. Karsif certainly is not alone in providing the comprehensive care offered by the Center for Breast Health. She works with a multidisciplinary team that includes medical oncologists and radiation oncologists, all of whom meet for a monthly tumor board to discuss difficult cases. While 
Dr. Karsif is the only dedicated breast surgeon at Good Samaritan Hospital, other general surgeons on staff who also have extensive experience in breast surgery are part of the center’s team. Dr. Karsif offers immediate breast reconstruction to all patients — whether they choose mastectomy or breast conservation via lumpectomy — and works with a plastic and reconstructive surgeon for that purpose.

The team at the Center for Breast Health also includes the following three individuals, who are integral to its success.

  • Patient navigator Ana Gonzalez helps steer patients through the breast cancer journey by working with them and 
Dr. Karsif to coordinate medical appointments. She also provides emotional support to patients and ensures they have the appropriate literature about breast cancer. Gonzalez encourages patients to take advantage of community resources that will make their lives easier, such as transportation assistance and organizations that offer wigs.
  • Genetic counselor Vanessa Marcell is certified in genetic counseling and plays a central role in the center’s broader effort to encourage women to think about the genetics of both their parents when considering their hereditary risk for breast cancer. At Good Samaritan Hospital, all women who have a screening mammogram are given a genetic screening form to fill out to help identify those at high risk for breast cancer based on family history (such women are also identified via office visits with Dr. Karsif). When a patient is identified as having increased hereditary risk for breast cancer, she and her family may meet with Marcell and may also choose to undergo genetic testing.
  • Patient coordinator Jennifer Goh worked with Dr. Karsif in New York Hospital Queens and takes care of the minutiae of patients’ treatment needs. She will eventually assume responsibility for coordinating all patient appointments.

Reaching Out

Community outreach and support for patients are two aspects of breast cancer care especially close to Dr. Karsif’s heart.

“I believe educating women about early awareness of breast cancer is a responsibility of mine,” she says. “I work closely with the head of outreach at Good Samaritan Hospital, and I’ve been out in the community at more places than I can count since arriving in Suffern. In March, we hosted our first cancer services program event at the hospital, which was made possible by a state grant via the American Cancer Society. The event provided underinsured and uninsured women with free mammograms, clinical breast exams and Pap smears. I plan to hold as many of those events as possible to meet the needs of the community.”

One of the features of the center’s future home in the medical office building will be a conference room, which will host meetings of a breast cancer support group currently being developed by Gonzalez and Dr. Karsif. The group will meet monthly and will be open to all comers.

Room to Grow

It is an exciting and hopeful time for the Center for Breast Health as it prepares to move into its permanent home, and the future holds even more promise. As the center grows, 
Dr. Karsif anticipates adding another dedicated breast surgeon to the team, as well as more support staff, such as physician assistants and patient coordinators. Dr. Karsif also envisions the center expanding its outreach network and solidifying its relationship with the American Cancer Society.

“My final message for referring physician colleagues is very simple: Breast cancer is a complex disease.  We understand the reality of being a woman and the fear that is associated with such a diagnosis. We provide a personalized, holistic, interdisciplinary team approach in working with our patients to ensure an outcome that gives the patient hope and the highest quality of life.” Dr. Karsif says. “We at the center are proud to make a difference in the lives of women in 
our community.”

Dr. Karsif is currently part of Ramapo Valley Surgical Associates at 100 Route 59, Suite 101, in Suffern. She is available in her office during business hours on Mondays, Wednesdays and Fridays.




MD News April 2011, Mid Hudson



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