Ordinationszeiten
Mo 15-18:00
Mi 8-11:30 und 14-17:00
Fr. 8-12:00
I support you with speedy clarification of conspicuous diagnostic findings be it in my office or as consultant at the breast health center at Klinik Favoriten. I organize an appointment for a breast biopsy for you. If tumors are visible on ultrasound, I can perform a biopsy in my office, if wanted. Within a few days I can discuss a treatment plan with you and perform breast surgery if necessary
General Information
Breast cancer is the most frequent type of cancer among women. Every 8th woman develops cancer during her lifetime.
This is the reason why in Austria as in many other countries there is a screening program for breast cancer. From the age of 45 every woman should go to mammography every two years. Between 40 and 45 you can participate voluntarily. In case of conspicuous findings (Birads 4 or 5) a further examination should follow. In many cases a breast biopsy is useful.
If breast cancer or a precursor is diagnosed, a breast surgery is necessary. The treatment of breast cancer consists of several pillars:
1)breast surgery to remove the tumor and the so called sentinel node,
2) irradiation if the breast is conserved and in some cases after mastectomy
3) systemic treatment, often endokrine (antihormonal) if the tumor is estrogen receptor positive and if not or agressive tumortype chemotherapie +/- antibody treatment might be helpful.
If there are several relatives with breast cancer in the family or the patient concerned is very young , genetic counselling is recommended. About 90% of the women suffering from breast cancer can be healed.
Breast Biopsy
In case of conspicuous findings of the breast a tissue sampling (biopsy) with local anesthesia is frequently taken. In most cases these kind of biopsies can be done by ultrasound. If the changes are visible only in the mammography, e.g. micro calcifications, an x-ray targeted aspiration biopsy can be necessary. These procedures are done on an outpatient basis and are usually not or only slightly painful. Pathological results are usually available within a week’s time.
Breast surgery
Most breast surgeries nowadays are breast conserving. The aim is to remove the deseased tissue, in case of cancer with a safety margin, and at the same time to preserve the shape and contour of the breast. This is possible with surgical experience and with the help of so called oncoplastic techniques. Here neighbouring tissue is used for covering. Therefore better cosmetic results can be reached. To detect the sentinel node a radioactive isotope or blue dye can be used, this helps to avoid systematic axillary node dissection in most cases.
Breast reconstrucion
If the breast tissue has to be removed, in many cases the skin as well as the nipple can be preserved. The breast itself can then be replaced by an implant, which can be placed either in front of or behind the breast muscle. This is also possible in case of a proposed post-irradiation. However, with a higher risk of a scarred shrinkage of the implant capsule. If a reconstruction with an implant is impossible, there is the possibility of reconstruction with the patient’s own tissue. In most cases, in which a removal of the glandular tissue is necessary, a reconstruction during the same surgery can be reasonable. If the result is not symmetrical a breast reduction surgery of the other breast can be done and is covered by health insurance.In case of a planned Irradiation a so called tissue expander can be used, this is an implant that can be partly filled with normal saline and can be reduced during irradiation to minimize side effects
Genetic counselling
If there are several women diagnosed with breast or ovarian cancer in a family line, genetic counselling can be useful. The current criteria for the health insurance to pay for genetic counselling are the following:
In maternal or paternal line, age at the time of diagnosis:
1 breast cancer before the age of 35
2 breast cancers, one of which before the age of 51
3 breast cancers, age irrelevant
1 breast cancer, 1 ovarian cancer at any age
2 ovarian cancers at any age
1 male breast cancer
In case of personal disease:
ovarian cancer in any case
Risk calculation
The personal risk to develop breast cancer can be calculated with the help of statistical programmes and used for consultation. In some cases of breast cancer it can be difficult to decide upon the treatment necessary. In these cases a calculation of the treatment benefits can be helpful.
Follow up care after Breast Cancer (and other gynecologic cancers)
After breast cancer, regular breast examinations and support for continuing anti-hormonal therapy are valuable. Many breast centers can no longer provide sufficient follow-up examinations for organizational reasons. I gladly offer this kind of follow-up examination always including breast ultrasound. Moreover, I am happy to discuss the question of duration of anti-hormonal therapy with you.
Benign breast diseases
Changes in the breast for many women are cause for concern. Some changes can be detected by oneself, e.g. during showering or putting on lotion. Other changes can be detected by the doctor during an ultrasound examination or mammography, e.g. cysts or micro calcifications. With many findings it quickly becomes clear that they are benign and do not raise the risk of breast cancer. With some breast changes further examination is necessary in order to find out the reason.
Frequent benign changes are fibroadenoma, inflammations, cysts.
Often it is not necessary to remove benign lesions from the breast.
Pap smear and cervical cancer screening
Regular examinations by the gynecologist help to identify a wide variety of diseases at an early, easily treatable stage.
The smear test (PAP) from the cervix is used for the early detection of cervical cancer and should take place once a year.
I also do a vaginal ultrasound scan of the uterus and ovaries and a palpation to assess the lower abdomen. The cervix is also examined with a colposcope (magnifying optics) to detect any small changes. In the event of a conspicuous Pap smear, you will be personally informed by us. An HPV (Human Papillomavirus) vaccination protects against cervical cancer and can also be useful for women who are not included in the vaccination program. If necessary, I will do an HPV smear test.
Pregnancy and maternity card
My offer ranges from the first examination after a positive pregnancy test to carrying out all examinations that should be done for the maternity card.
Ultrasound examinations are also carried out during all pregnancy check-ups, and I can give you print out pictures of your baby.
Up-to-date pregnancy care also includes information about useful and recommendable ultrasound examinations to detect possible malformations (nuchal translucency measurement, combined test, organ screening, NIPT Test).
I can help you to choose a maternity clinic and put you in touch with a midwife care service.
Since my work at the breast health center does not allow me to be on call, I currently only offer birth care for a planned caesarean section.
Contraception
Pill, patch, ring, stick, IUD, natural contraception, ligation…
With so many methods, it is often difficult to get a clear view.
I can help you to find a suitable contraceptive method in a detailed consultation.
The birth control pill is still the most widely used contraceptive. It was also a major achievement that led to women´s self-empowerment. Nevertheless, the pill also has certain side effects, which I point out in a consultation. Teenagers should also think about other contraceptives until their first pregnancy.
If an unwanted pregnancy occurs, an abortion up to the 12th week of pregnancy is legal and possible in Austria as part of the time limit solution. This can be done with medication or with a curettage.
Copper IUD, Gold IUD, hormonal IUD
The copper IUD (intrauterine device), is a usually T-shaped plastic structure wrapped in copper wire that is inserted into the uterine cavity during menstrual bleeding, since the cervix is slightly open at this point.
The insertion is carried out with local anesthetic and is normally not painful. It is followed by an ultrasound check to assess the position of the IUD.
The copper ions have an inhibitory effect on sperms and nidation and thus prevent pregnancy. The effect is limited to the uterus. The lifespan is generally 5 years.
With the gold IUD, the core of the copper wire is made of gold and is therefore more resistant to corrosion. This should allow for a longer stay. However, the approval of the product and the manufacturer’s recommendation is only for 5 years. Moreover there have been quality issues with gold IUDs in recent years.
The menstrual period can become heavier with an IUD.
The hormonal IUD continuously releases luteal hormone (Progesterone like), which causes the mucous membrane of the uterus to shrink. As a result, menstrual bleeding becomes weaker or stops altogether. The effect is only local. The luteal hormone also appears to have an anti-inflammatory effect.
In the past, IUDs were only used if a birth had already taken place. Most IUDs are now also available in small sizes and can therefore also be used when there has been no pregnancy. A IUD can also be used for young women.
Ultrasound
A vaginal ultrasound examination can usually show the uterus and ovaries well. This method is a useful addition to any examination at the gynecologist and is carried out by me as a matter of routine. At every check-up I also perform a breast ultrasound. During pregnancy an ultrasound examination is an important part of prenatal care, in order to assess the vitality, growth and position of the unborn child.
Gynecologic Surgery
Beside breast surgery I also offer other gynecologic surgery, like D+C (Curettage), conization, laparoscopy (abdominal endoscopy), hysterectomy, fibroid removal, ovarian surgery, and other procedures.
These operations can be carried out in Klinik Favoriten or if wished in a private hospital.
HPV, infection,vaccination
Virus & Transmission
Human papillomaviruses are a large group of viruses that can lead to abnormal cell growth in humans and can cause precancerous lesions, cancer and genital warts. There are more than 200 known types of HPV, at least 14 of which have cancer-causing effects. Human papillomaviruses are transmitted through direct contact with the mucous membranes, for example during sexual contact or, in rare cases, during childbirth from mother to child. There is a risk of infection as long as there is a (chronic) infection. Condoms do not offer reliable protection against infection with HPV.
Certain types of virus can lead to unpleasant, contagious, rapidly growing, stubborn skin changes, primarily in the genital area (genital warts), which sometimes have to be removed with special ointments or by surgery and tend to recur.
Infections with cancer-causing HPV types (types 16 and 18), for example, are responsible for over 70% of all malignant cases of cervical cancer. Infections with these types are initially asymptomatic and in most cases heal spontaneously within 1 to 2 years. Long-standing infections lead to precancerous lesions and cancer of the cervix, vagina, vulva, penis, anus, pharynx, larynx and esophagus. The treatment of the cancer diseases mentioned or their precursors can be successful if diagnosed in good time, but leads to physically and mentally stressful treatments that can be associated with hospital stays, operations and the administration of chemotherapy. For the early detection of cervical cancer, the cancer smear (PAP test) is carried out as part of the gynecological check-up. If there is a suspicious finding that is confirmed in the further examination (=colposcopy, approx. 60,000/year in Austria), an operation on the cervix (=conization, in Austria per year approx. 6,000) may be necessary. These increase the risk of preterm birth in later pregnancies.
Human papillomaviruses (HPV) are distributed worldwide. About 80% of all women and men will be infected with genital HPV during their lifetime. Cervical cancer is the third leading cause of cancer-related death in women worldwide. In Europe, 33,500 new cases of cervical cancer with about 15,000 deaths are registered every year, in Austria about 400 new cases of cervical cancer or 130-180 deaths.
Genital warts are also extremely common. More than 1% of sexually active people suffer from genital warts. Overall, every 10th person will develop genital warts during their lifetime.
The vaccination reduces the risk of genital warts and cervical cancer by up to 90%, and the risk of cancer of the throat, larynx, vagina, anus and penis is also significantly reduced. Vaccination against human papillomaviruses contains those virus types that most commonly cause the diseases described and is recommended for everyone up to the age of 30, after which it is optional. The greatest personal benefit is achieved by vaccination before engaging in sexual activity. People who are already sexually active can also benefit from the vaccination. Vaccination offers the best protection against the virus types contained. Girls and boys as well as women and men are affected by HPV diseases. Vaccination of people of both sexes is also important to break the chain of infection in the population. Gynecological check-ups (incl. PAP smear and HPV test for women over 30) should continue to be carried out at the recommended intervals, regardless of the vaccination.
The HPV vaccination will be available free of charge from February 1st, 2023 from the age of 9 to the age of 21. In this age range, 2 doses in the 1+1 scheme are recommended. The 2nd dose should be administered after a minimum of 6 months and a maximum of 12 months. From the age of 15 to 21, the use of the 2-dose scheme is off-label use, which is recommended according to the Austria 2023 vaccination plan.
From the age of 21, HPV vaccination is recommended in a 3-dose scheme.
Since the greatest benefit of the vaccination occurs when it is given at a time when no contact with HPV has taken place, i.e. ideally before the first sexual contacts take place, vaccination is recommended from the age of 9 years. Research has also clearly shown that children in this age group respond best to the vaccine. The antibodies formed can optimally prevent the viruses from penetrating the body cells and thus preventing the infection.
After a conization (surgery on the cervix due to precancerous stage) an HPV vaccination is recommended, up to the age of 45 this is covered by the Austrian health insurance companies.
In the case of negative HPV results, a vaccination may also make sense. I would be happy to advise you in a personal conversation
Fertility Problems
In the case of fertility problems the systematic step-by-step examination of both partners is important in order to find a possible cause. These include hormone status, spermiogram (semen findings), infection swab, ovulation test and checking the patency of the fallopian tubes.
If further support is wanted, I help you to find a suitable fertility clinic and do the pre-assessment.
Teenage consultation
Young girls are often very afraid of their first visit to the gynecologist, although a gynecological examination is often not even necessary.
Frequently, it is about contraception, which can be clarified in a conversation.
Such a consultation can take place with the mother or, from the age of 14, alone.
Since cervical cancer is essentially a disease caused by the HPV virus, a smear test from the cervix is not necessary before the first sexual intercourse.
Menopause
Many women experience menopause as stressful. In addition to hot flashes and joint problems, mental discomfort and bone loss (osteoporosis) can also occur. From herbal to homeopathic substances to hormone replacement therapy, there is the possibility of alleviating these symptoms.
Hormone replacement therapy can be done safely for up to 5 years without increasing breast cancer risk. It is helpful in order to reduce menopausal symptoms, but not prophylactic strategies.
A slight increase in the risk of breast cancer is only to be feared if the drug has been taken for more than 5 years. The dosage is nowadays as low as possible and can be adjusted individually.
Perchtoldsdorfer Straße 7/7
1230 Wien
Monday 3:00pm-6:00pm
Wednesday 8:00am-11:30 am and 2:30pm and 5:30 pm
Friday 8:00am-12:00am
Arrange your appointment online Termin buchen, by telephone during the opening hours or by leaving a message.
Tel.: 01/960 73 24
Mobil: 0699/142 18 669
Mail: ordination@frauenarzt-sagmeister.at
Curriculum vitae
Additional trainings, skills
Personal Information
The standard examination always includes a gynecological examination with smear, ultrasound and breast examination with breast ultrasound and costs 140€. If multiple services are combined, the price remains the same, except for simultaneous genetic counselling or IUD insertion.
| breast examination for an abnormal breast finding | 140€ |
| genetic counselling for a family history of breast or ovarian cancer risk | 140€ |
| maternity pass examination | 100€ |
| standard consultation | 140€ |
| pregnancy – first examination | 140€ |
| Pregnancy – Follow-up examination | 100€ |
| copper IUD, gold IUD | 350€ |
| hormonal IUD, gynefix | 450€ |