Even before the inception of national Breast Cancer Awareness Month in 1985, Dr. Kamilia Kozlowski, a Clinical Breast Radiologist, launched Knoxville Comprehensive Breast Center, or KCBC as it is commonly known. Recognizing the challenges that women with breast related health issues faced, Dr. Kozlowski founded KCBC in 1983. A woman friendly, vertically oriented, streamlined, and cost-effective alternative to the fragmented and inefficient system of breast health care then in existence, Knoxville Comprehensive Breast Center has been at the forefront of providing women with the dedicated education, screening, diagnosis, and treatment resources needed to combat breast cancer. A pioneer in her field, Dr. Kozlowski and her team of 73 compassionate and caring team of health care professionals have served as an inspiration of other independent medical centers across the country dedicated exclusively to women’s breast health.
During the month of October and the 32nd anniversary of Breast Cancer Awareness Month, it is indeed our pleasure to feature Knoxville Comprehensive Breast Center.
EK: Dr. Kozlowski recognized early on in her career that women’s breast health care was being delivered in a fragmented and inefficient manner. How was that impacting women with breast related health issues?
KCBC: In the late ’70s or early ’80s, modern mammography began with the development and use of mammographic machines with better resolution and lower radiation doses than the general radiology machines that were being used for breast imaging at the time. These machines were located in the general radiology department at the hospital, so women had to sit with other patients having all types of x-ray procedures. There were no breast centers in Knoxville at the time, and less than 10 independent centers existed across the United States. In those early years, women with an abnormal mammogram report were referred to a general surgeon for further evaluation. Generally, a physical exam was performed and they were scheduled for surgery. The period of time between their appointments and the period of time for women to get the results of their testing could sometimes take weeks.
Dr. Kozlowski realized there was a better, more vertically oriented way to provide breast healthcare to women and established KCBC in May of 1983 in order to provide it to the women of Knoxville. Dr. Kozlowski found that if there was an indeterminate mammographic finding, breast ultrasound was very useful in evaluating whether it was benign or suspicious enough to warrant a fine needle biopsy. If the biopsy was essential, she performed it at the time of the initial visit. Women received the results of their breast imaging studies before leaving the office. This placed breast health care in the hands of the clinical breast radiologist, who was then responsible for examining the patient, communicating their negative results, and making the diagnosis of breast cancer. The previous way of referring the woman from one doctor’s office to another with a delay in diagnosis only increased the patient’s anxiety.
Dr. Kozlowski was one of the first dedicated clinical breast radiologists in the country who took on the role as the primary doctor for the diagnosis of breast disease. These clinical breast radiologists were no longer just sitting in the reading room; they were also examining patients and interacting with them, taking care of their breast health needs and questions. Breast cancer diagnosis was no longer a surgical specialty, but rather an imaging specialty for breast cancer diagnosis with the clinical breast radiologist accepting the role of the patient’s primary care breast doctor.
EK: How has KCBC’s concept of combining education, screening, diagnosis, and treatment within a single medical center dedicated to women’s breast care helped further women’s breast health in our community?
KCBC: Within 18 months of opening KCBC, the hospitals in the area updated their own mammographic equipment to state-of-the-art mammographic machines available at that time. Soon afterwards the hospitals began to move their mammographic equipment into a specified area separate from the general radiology department. Dr. Kozlowski was the primary agent in changing breast health care delivery in Knoxville not only with the development of KCBC, but also by indirectly influencing change in the surrounding hospitals.
EK: There are a variety of other area medical facilities that offer similar health related services. At KCBC, however, you are dedicated 100% to women’s breast health care. Why should your commitment to remaining focused exclusively on breast health be important to women?
KCBC: Of all the cancers that afflict women, breast cancer is the most emotionally charged cancer. It is closely interconnected with a woman’s physical appearance and her sensuality and intimacy. It is a very sensitive issue for women to undergo yearly imaging and possibly be faced with being told she has indeterminate findings or, worst yet, that she has breast cancer. At KCBC, although we offer similar services to other medical facilities in our area, we offer a much better experience in the delivery of those services. Our clinical breast radiologists specialize in, and read, only one type of imaging all day long. We specialize in breast health care and we are not distracted from that… ever. Women are treated in a kindhearted manner from the moment they open our doors and enter into our “spa-like” setting. At KCBC, patients are treated compassionately throughout every stage of their visit.
KCBC will always be dedicated 100% to women’s breast health care. Because we are exclusively devoted to this field and remain an independent breast center, we are, and always have been, free to incorporate the newest technology and treatments in the realm of breast health care. Through the last 34 years, KCBC has led the way in Knoxville with being the first to institute the latest improvements in breast health care.
EK: Many of our women readers delay (or ignore altogether) the need for screening. What encouragement would you offer them?
KCBC: It is so very important for them not to delay in having their yearly breast imaging studies. Aside from skin cancers, breast cancer is the number one cancer that affects women. More than 200,000 women are diagnosed every year in the United States. What they often do not know is that 80% of all breast cancers diagnosed every year afflict women who have no family history of breast cancer! What is also not commonly known is that our chances of getting breast cancer increase as we get older. One in 227 thirty year olds get breast cancer, one in 68 forty year olds, one in 42 fifty year olds, one in 28 sixty year olds, one in 26 seventy year olds, and up to one in eight eighty year olds. The best screening interval is one year as the average doubling in size of a breast cancer is one year. It is best to find and treat a breast cancer when it is small, thus giving women more options to have conservative breast surgery and reducing adjuvant treatments.
EK: KCBC offers its patients a variety of screening technologies, including screening mammograms, ultrasound, and MRI. Tell our readers a little about each of these diagnostic tools.
KCBC: A screening mammogram uses special x-ray technology specially designed for breasts to detect abnormal growths or changes in breast tissue. It is currently the best defense against breast cancer, as the x-rays can detect tumors and growths in early stages.
A breast MRI, or Magnetic Resonance Imaging, involves a specially-designed machine that provides high-resolution imaging while maintaining breast sensitivity and comfort. The MRI technology takes several images throughout the breasts at less than 1mm of thickness. Those images are combined to generate detailed pictures. MRI machines do not use x-ray but rather a combination of radio and magnetic waves. A magnetic field is put around you while radio waves are directed at specific areas of your body. In the AURORA® Dedicated Breast MRI machine that we have in-house at KCBC, both breasts are scanned simultaneously. The machine also allows for feet-first entry, which can alleviate some of the anxiety associated with having an MRI.
Breast ultrasound uses sound waves to make images of the breast. Breast ultrasound is non-invasive and is often used as a follow-up test after an abnormal finding on a mammogram, breast MRI, or clinical breast exam. Studies have shown mammography combined with breast ultrasound finds more breast cancers than mammography alone in women with dense breasts.
EK: Why is it important that KCBC have clinical breast radiologists on your staff?
KCBC: It is important to have clinical breast radiologists on staff who are solely engaged in breast imaging because it has been proven in the medical literature that dedicated breast radiologists have the highest sensitivity for breast cancer detection. Additionally, by being clinical, our radiologists interact face-to-face with our patients, addressing all their breast concerns and also explaining in a clear way what may or may not be of concern when reviewing their images with them. This is not a common practice in breast centers, as the quality of service varies from breast center to breast center. Dr. Kozlowski truly believes that it is an important feature of a breast center to educate women in breast health care while alleviating their fears of having breast disease.
EK: In addition to those services you’ve already described, what other services do you offer in-house?
KCBC: For the past 16 years, we have also offered genetic high-risk counseling and screening services. Genetics has become increasingly more important in cancer prevention, as well as in alleviating the concerns of those patients who were once overwhelmed with the thought they were at high risk. In addition to detecting breast and ovarian cancers, the hereditary cancer panel also tests for other mutations for cancers such as gastric, colorectal, pancreatic, melanoma, endometrial, and prostate.
KCBC also has the Unique Boutique, which is located in our main lobby. We have a mastectomy fitter who will fit patients for prosthetics and assist them in obtaining the products they need. The Unique Boutique also provides the latest products for women who have had breast surgery or are currently having breast surgery such as an array of lotions, post-mastectomy garments including swimsuits, and head coverings such as scarves and wigs. We also offer a wide variety of other retail items and gifts such as jewelry, clothing, candles, and more.
EK: Education and outreach are important components of Knoxville Comprehensive Breast Center’s overall mission to our community. Tell us about your upcoming 12th Annual Mission Mammography.
KCBC: One of KCBC’s missions to our community was to provide mammography screening to all women who needed it. We discovered that many women had difficulties in finding access to quality mammography services due to their busy schedules, work duties, lack of transportation, and family responsibilities, so in 1986, we started our mobile screening program, which was the first such program in Knoxville and one of only a few nationwide. While traveling to provide services to women, we realized that a number of them lacked insurance coverage or had a very limited means with which to pay for screening mammography or diagnostic services. The Kim Rowden Breast Cancer Memorial Fund was established by KCBC to help these women.
Every year we hold a “Mission Mammography” event where we provide mammograms for free to women in Knoxville and surrounding communities who don’t have health insurance. This year we will be hosting our 12th Mission Mammography starting with a kickoff event on October 4th from 7 am to 1 pm. Women without insurance can come at any time during the kickoff event or any time throughout the month of October, and we will provide them with a mammogram funded by the Kim Rowden Breast Cancer Memorial Fund. We encourage uninsured women to take advantage of these free mammograms during October, which is Breast Cancer Awareness Month.
EK: In closing, is there anything else you would like to add?
Dr. Kozlowski: It has been a special, and at times a difficult journey, which all started in 1983 when I had the passion to find early breast cancer and believed it was time to change the delivery of breast health care. It has been personally gratifying for me to accomplish this goal. In closing, to try in an endeavor is to risk failure, but to risk and succeed is most rewarding with a peaceful sense of fulfillment and gives encouragement to others to risk pursuing their dreams.
Knoxville Comprehensive Breast Center
1400 Dowell Springs Boulevard, #200
Knoxville, TN 37909