Cancer Care

The Department of breast diseases (called « Sénopôle ») of Saint-Louis Hospital is a unique ambulatory structure gathering medical oncologists specialized in breast cancer and benign preneoplastic breast diseases, breast cancer surgeons, reconstructive surgeons, experts in post-tumor resection, specialists in plastic breast reconstruction, and breast radiologists with mammography and ultrasound equipment at their disposal, all working together in an integrated way. Patients are referred from the northern and eastern parts of Paris by general practitioners and community gynecologists, with a dedicated fast-track pathway allowing the diagnostic management of suspicious breast nodules in one day within the same unit and including consultation with an oncologist and a surgeon as well as radio-guided biopsies, followed by the psychologist, plastic surgeon, and radiotherapist consultations. All patient files are discussed in a multidisciplinary tumor board (MTB) gathering the Lariboisière and Saint-Louis surgical teams and the medical breast oncology team. Indeed, depending on where they live, some patients are referred to the Department of gynecological surgery of Lariboisière Hospital, where the same fast-track diagnostic pathway is also organized with dedicated mammography and ultrasound equipment and surgery consultations. The consultation to announce the histological diagnosis of cancer and the therapeutic strategy takes place at Saint-Louis hospital before the initiation of treatments, which are either loco-regional (surgery with or without radiotherapy) or systemic (neoadjuvant or adjuvant chemotherapy). A palliative care strategy is planned early on, including consultations with palliative nurses, physiotherapists, and pain doctors at the Sénopôle, according to the schedule set up by the liaison coordinating nurses. For patients with loco-regional disease, systemic treatments are administered within the Sénopôle. For patients with metastatic disease originating from Saint-Louis but also Lariboisière, Bichat, and Louis Mourier Hospitals, systemic treatments can also be administered at the ambulatory day hospital of the Saint-Louis Department of medical oncology. Reconstructive breast surgery is also offered at Saint-Louis Hospital, with a dedicated surgery department. At Bichat Hospital, which covers the northern suburbs of Paris as well as some western suburbs (92: Nanterre, Colombes), patients are referred to the Department of gynecological surgery by general practitioners and community gynecologists. A weekly MTB takes place at Bichat Hospital with the breast oncology team from the Sénopôle; surgical treatments are carried out at Bichat Hospital, while reconstructive surgery, radiotherapy, and systemic treatments are performed at Saint-Louis Hospital, with a common electronic patient file and PACS (Pictures Archiving and Communication System) allowing a perfect continuity in the patient pathway between the different hospital sites.

Thus, the three main hospital sites of the Cancer Institute AP-HP Nord (Lariboisière, Bichat & Saint-Louis Hospitals) have the second largest breast cancer activity of Paris, the first of the AP-HP network, and the third of the whole Ile-de France region, with nearly one thousand new patients per year.

Our strong translational and clinical research activity relies on a historical network gathering clinicians, onco-geneticists, pathologists, and basic science researchers: