Surgical oncologist Monica Morrow is an internationally renowned expert in breast cancer with more than 20 years of experience leading research, education, and treatment programs, most recently at the Fox Chase Cancer Center, in Philadelphia. She joined Memorial Sloan-Kettering Cancer Center in 2008 as Chief of the Breast Service and co-leader of the Breast Disease Management Team. She is the incumbent of the Anne Burnett Windfohr Chair of Clinical Oncology.
I've always been interested in anatomy and what's inside the body. When I was in first grade, growing up in suburban Philadelphia, I brought the heart and lungs of a cow to school -- which I don't think my teacher much appreciated. I'd gotten them from a butcher for show-and-tell.
Later, I enrolled in a combined five-year college and medical school program at the Jefferson Medical College, in Philadelphia. I soon became attracted to surgery. In the 1980s, I trained as a surgical oncology fellow at Memorial Sloan-Kettering and practiced general surgical oncology early in my career before specializing in breast cancer surgery.
Breast surgery is actually somewhat different than many surgical fields -- and this is true of a lot of areas of cancer care -- in that it involves a great deal of long-term patient interaction. It's also challenging because breast cancer is an extremely complex disease. It's becoming increasingly clear that the underlying biology of breast cancer has a major impact on the outcomes of things we have traditionally thought to be related to the mechanics of surgery. For example, there is an ongoing debate about how big a margin [healthy tissue] a surgeon needs to remove when doing a lumpectomy in order to ensure that the cancer will not come back in the affected breast. The debate began when we treated patients only with surgery and radiation. However, we now know that the use of targeted therapies such as tamoxifen, which target estrogen receptors on tumors, can dramatically reduce the risk of cancer recurring in the breast -- and so you may not have to remove as much breast tissue. As we incorporate more of that sort of information and understand it from a surgical perspective, we'll be able to tailor the intensity of local treatment [surgery and radiation] more precisely. This is the next big frontier in breast cancer surgery.
Being back at Memorial as Chief of the Breast Service has been a pleasure. In returning, I was attracted by the Center's unique opportunities. We treat more breast cancer patients than any other center in the nation, and Memorial Sloan-Kettering has all the resources necessary to be at the cutting edge of developing new treatments. I came here with the goal of taking full advantage of the wealth of expertise and assets to address important issues in breast cancer and patient care.
Advances in breast cancer surgery are very much based on evidence from clinical trials. So, while we continue our contributions to nationwide surgical clinical trials, we also need to more aggressively pursue our own trials to address issues important for patients at Memorial Sloan-Kettering. The sentinel node biopsy story is a great example of something that did not begin here at Memorial, but in which Memorial Sloan-Kettering surgeons took a lead role to answer important questions about the clinical applications of sentinel lymph node biopsy in the treatment of breast cancer. We need to be doing more of this kind of work.
