Navigating Breast Care
Cape Cod Healthcare’s breast health navigators are often the first reassuring voice patients hear, offering guidance, comfort and a clear path during an overwhelming time.
We recently sat down with Pat-Ryan Blanchard, Nicole Salter and Ann Coggeshall, three of the four members of Cape Cod Healthcare’s breast health navigation team, to learn more about their work (not pictured: certified navigator Kathy Murray at Seifer Women’s Health and Imaging Center). These experienced professionals bridge the gap between patients and providers, ensuring that each person receives compassionate, coordinated care from diagnosis through treatment and beyond. Through their empathy and expertise, they help patients feel supported, informed and never alone on their journey.
Pat-Ryan Blanchard, NP: Guiding the ship through a patient’s journey
Pat-Ryan Blanchard, NP
Certified Breast Health Navigator | Cuda Women’s Health Center
For more than three decades, Pat-Ryan Blanchard, NP, has been a constant presence at Cape Cod Healthcare, guiding patients through some of the most vulnerable moments of their lives. As a breast health patient navigator at Cuda Women’s Health Center, her role is part educator, part advocate, part steady hand.
“I like to look at navigation the way we look at the ocean here on the Cape,” says Pat. “A navigator is someone who guides the ship. That’s what I do. I help guide patients through the entire process from beginning to end.”
Pat’s career in oncology began in Boston, where she worked on hematology/oncology units and in cancer specialty clinics. In 1990, she joined Cape Cod Healthcare. “I’ve been here since the early days—when we were just beginning to build oncology programs,” she says. “I’ve seen the evolution from one breast radiologist to full multidisciplinary teams, advanced technology and comprehensive cancer care.” Over the years, she has helped shape the hospital’s oncology programs, from the first imaging departments to the opening of Cuda Women’s Health Center.
Her work as a patient navigator is also deeply personal. Years ago, Pat faced her own cancer diagnosis—a moment that forever deepened her empathy and strengthened her commitment to patients. “When you’ve been on the receiving end, you understand in a different way,” she says. “You know the fear, the questions, the uncertainty. But you also know there’s hope.”
Pat is often the first voice a woman hears after an abnormal mammogram, helping to coordinate diagnostic tests, consultations and follow-up care. She provides education about each step, answers questions and connects patients to support services, including funds that help ease financial burdens under the Early Detection Fund. “Patients here have so many team members involved in their care,” she says. “The role of a navigator provides emotional support and continuity of care to women while helping with overall coordination of services throughout their journey.”
Delivering a cancer diagnosis, she admits, never gets easy. “It’s very difficult to give someone that news because at that moment, their life changes,” Pat says. “My approach has always been to give hope, empathy and compassion—because breast cancer is treatable and survivorship is real.” Seeing patients return year after year as survivors is what she finds most rewarding.
Pat has also witnessed enormous advances in care over her long career—from digital imaging to genetic testing and targeted therapies. “We’ve made huge strides,” she reflects. “These innovations give patients more options, better outcomes and more years with their families.”
Whether she’s coordinating appointments, leading support groups or simply offering a reassuring word, Pat remains dedicated to being that guiding hand. “Nurses have always been navigators,” she says. “We meet people in moments of crisis, and if we can help them find their way through it, that’s everything.”
Nicole Salter, NP: Navigating Breast Health ‘Beyond the Pink’
Nicole Salter, NP
Certified Breast Health Navigator | Seifer Women’s Health and Imaging Center
For Nicole Salter, the path to breast navigation was a seamless extension of her career in compassionate care.
“I don’t believe that there was one story or incident that inspired me to become a clinical breast navigator,” says Salter, MSN, APRN, ANP-BC, BHCN. “As a healthcare professional, I have always wanted to simply help people. The role of a breast navigator enables me to lead with compassion, educate with my experience and offer support to people during a scary time. A job I feel I was meant to do!”
Nicole has been an NP for almost 20 years and started working in breast health three years ago. She spent 15 years in primary care on Cape Cod, including six years with Medical Affiliates of Cape Cod through Cape Cod Healthcare. “When I read about the position as an NP working in breast health, I instantly knew that I was the person who could not only do the job,” she says, “but would be an excellent fit for me both personally and professionally.”
She began her breast health career at the Cuda Center in Hyannis and now works at Seifer Women’s Health and Imaging in Falmouth, where she also serves as a breast navigator. “I now have the opportunity to help serve the community in which I live,” she says.
Every day looks different. Nicole reviews abnormal breast imaging, schedules additional imaging and biopsies, supports patients during procedures and collaborates with radiologists, surgeons and technologists. “Breast navigators can be considered a bridge between patients and providers as we attempt to limit barriers to care and streamline the complex process of breast cancer diagnosis and treatment,” she says.
Above all, says Salter, the navigators are here to help, guide and support patients through a potentially scary and anxiety-provoking time. “It is important to understand that there is so much more ‘beyond the pink,’” she says. “Maintaining a woman's breast health is our world year-round!” Navigators focus on routine screening, breast cancer prevention education, risk assessment and genetic counseling. Comprehensive support is also provided to survivors and caregivers during and after treatment.
“Every patient teaches me something,” Nicole reflects. “One in eight women in the United States will develop breast cancer in their lifetime. This statistic is astounding and emphasizes the importance of the role of the breast health program in healthcare. It’s a privilege to be a part of the awesome breast health team through Cape Cod Healthcare.”
Ann Coggeshall: Finding Strength in Her Patients’ Resilience
Ann Coggeshall
Certified Patient Navigator | Cape Cod Healthcare Breast Surgery, Cuda Breast Care Center
One patient’s story has stayed with Ann Coggeshall. The woman had just completed treatment for another cancer when she received a new breast cancer diagnosis. “She couldn’t seem to catch a break,” says Coggeshall. “Despite all of this, she remained positive and hopeful and is one of the most kindhearted patients I have ever encountered. Her journey is a constant reminder for me to always be grateful for my health and the health of my family because everything could change in an instant.”
That experience, like so many others, reflects why Ann chose this path. “I have always wanted to work in healthcare, especially in a role that directly helps others and has a positive impact on their lives,” she says.
Ann has been with Cape Cod Healthcare for 15 years, starting in medical records at the former Breast Care Center before becoming a float secretary for Cuda Imaging. In 2015, she supported the launch of the genetic testing program, where she first met the breast surgeons who helped shape the navigator role. She became a certified patient navigator for breast surgery in the spring of 2017.
A typical day involves meeting with patients and families after surgical consults or post-op visits with Jill Oxley, MD, and Naomi Kalliath, DO. She coordinates surgeries, imaging, referrals, follow-ups and connects patients with support groups, wellness programs and community resources.
“I explain to our patients that I am their central contact through their surgical journey,” says Coggeshall. “Any questions they may have or barriers they face, I encourage them to reach out. If there is a question I cannot answer, then I know where to go for that information.”
“The most rewarding part is the relationships I form with patients and their families and still being able to see them at their follow-up visits years after their initial diagnosis,” says Coggeshall. “The most difficult is having a front-row seat to our patients and their loved ones going through one of the scariest times of their lives.”
She approaches each interaction with empathy and care. “We have all gone through difficult times, whether it’s something affecting you personally or affecting a loved one. It can be confusing and scary. I approach every patient interaction with the mindset that ‘this could be you’ and offer the support I would expect if this were my mother or sister or friend being diagnosed with breast cancer.”
For Coggeshall, being a trusted “lifeline” is an honor. “It means that they feel safe, respected and are confident that I will act with their best interests in mind.”
