When patients first come to see me, they are often scared because they have been told they have a potentially life-threatening disease, or perhaps because they are afraid of being disfigured. Many newly diagnosed patients are also confused because there is so much information out there about breast cancer, some of which is incorrect, that it is hard for them to figure out what applies to them and what does not.
I truly believe that knowledge is power, and it’s important to distinguish between what is scientific fact and what may be someone else’s personal experience. My goal is to provide people with the information they need to understand their disease and face the challenge of treatment. We also cannot know every treatment a person will need based only on a biopsy that shows breast cancer, so I explain that the treatment process unfolds step-by-step. I try to allay the sense of panic that often comes with diagnosis to allow people to be more comfortable as their treatment journey unfolds.
The way we treat breast cancer began to change dramatically during my training to become a surgical oncologist. It’s been wonderful to be able to offer patients improved, less radical surgical approaches. Breast cancer is a common disease that affects people of all ages and races and ethnicities. It runs the spectrum, from very aggressive to very slow-growing. Understanding how best to treat each individual and their cancer is a challenge that has kept me dedicated to clinical care and research throughout my career.
My research has focused on how to apply advances from clinical trials to daily surgical practice. I am currently investigating how treatment choices for breast cancer surgery are made — such as how well patients understand their options and when it is more beneficial for a person newly diagnosed with breast cancer to have chemotherapy before surgery to reduce the extent of the operation.
I have co-chaired two joint committees of the American College of Surgeons, American College of Radiology, and College of American Pathologists: Standards for Breast Conserving Therapy for Invasive Breast Cancer (2002), and Standards for Breast Conserving Therapy in Ductal Carcinoma In Situ (DCIS) (2007). I also co-chaired committees for the Society of Surgical Oncology (SSO) and American Society for Therapeutic Radiation Oncology (ASTRO) to develop standards for margins for lumpectomy in invasive breast cancer (2013) and DCIS (2015), and I have served as an Associate Editor of JAMA Oncology since 2014.
I am the surgical editor of the textbook Diseases of the Breast and a co-author of Breast Cancer for Dummies. I was the 2012–13 President of the Society of Surgical Oncology, the professional organization for surgeons who specialize in cancer treatment.
