2009 Alliance Breast Surgery Fellows
This year, the Breast Cancer Alliance awarded three breast surgery fellowships to encourage young breast surgeons to choose breast surgery as a career path.
2009 Debbie Taylor Breast Surgery Fellowship at Beth Israel Medical Center/St. Luke’s Roosevelt Hospital Center, Continuum Cancer Centers of New York: Sumy H. Chang, MD
In honor of long-time board member and supporter Debbie Taylor
Dr. Sumy Chang has been training as a breast surgeon for only a short time, but she is already completely immersed in a heavy schedule, seeing patients three days a week and working in the operating room the other two days. As a new breast surgery fellow, she’s busy.
So far, her routine has brought her in contact with an astounding variety of patients. “I’ve seen both women and men and patients as young as 20 or as old as 80. Some are newly diagnosed, while others are following up on cancer they had a decade ago,” she says. Some of her patients are receiving close attention because of a strong family history of breast cancer, even if they have not developed the disease. And although the majority of her patients have breast cancer, that isn’t true of everyone – some have benign breast disease, including breast pain.
Dr. Chang notes, “We spend a good deal of time screening patients to make sure we understand what we’re seeing. We don’t want to rush the patients to the operating room at the first sign of disease. We take the time to review the imaging and pathology, and we work closely with the oncologists. We also consult with patients about their options, such as lumpectomy versus mastectomy, so that when they receive their treatment, they have been thoroughly evaluated and they are well-informed about their choices.”
A large part of Dr. Chang’s job is to review pathology reports and assist with operations. Although she spent five years as a surgical resident, she doesn’t feel quite ready yet to take the lead. She explains, “I need to develop the specific thinking and skills that are required for breast surgery. Because the research and protocols for treatment of breast diseases change rapidly, I can’t rely on skills attained during my general surgery training.”
Is her experience so far what she expected it would be? “The one thing that surprises me is how many people I see coming in with late-stage disease,” she says. “These are women of every age and every socio-economic status. I find that remarkable in a city like New York, where there is so much information available and so many examples of women who have survived breast cancer. Unfortunately, I think it is difficult for many women to face this disease when it becomes personal.”
Dr. Chang’s goal from her year-long fellowship is to emerge with a better understanding of both breast cancer and benign breast disease. She hopes to work at a large breast center as she enjoys having the multi-disciplinary support offered by institutions with many resources.
Dr. Chang was born in Burma and raised in Brooklyn, where her parents emigrated when she was young. She holds a BA in Biology from Vassar College and attended medical school at The SUNY Health Science Center in Brooklyn, NY. She completed her surgical residency at Staten Island University Hospital. She enjoys cooking and exploring restaurants in New York City in her spare time.
2009 Norma Lies Mitchell Breast Surgery Fellow, Yale School of Medicine: Eliza-Jasmine Baotran Tran, MD
In honor of Norma Lies Mitchell, mother of Jack and Bill Mitchell of Richards of Greenwich/Mitchells of Westport
Eliza-Jasmine Baotran Tran’s fellowship is built on a multidisciplinary approach that extends to the care of Yale’s breast cancer patients. That means that between the time of initial diagnosis and initiation of treatment, patients are likely to have seen most, if not all, of the Breast Center’s multidisciplinary team members: radiologist, medical oncologist, breast surgeon, plastic surgeon, radiation oncologist, medical geneticist, and social worker. As the breast surgery fellow, Dr. Tran interacts with and learns from all the members of the team about communicating and coordinating patient care. She attends weekly multidisciplinary cancer conferences and is placed on dedicated rotations, spending a month on each: radiology, pathology, medical and radiation oncology, and, she hopes, plastic surgery. She has already completed her breast surgery and pathology rotations. During her breast surgery months, Dr. Tran participated in initial evaluation of patients and preoperative and postoperative care as well as surgeries of patients with either benign or malignant breast disease. In the outpatient setting, her clinic patients have presented at varying stages in their care, ranging from initial review of a suspicious lump to evaluation of an abnormal mammogram, and continuing on to preoperative evaluation, postoperative follow up, and long term post-treatment surveillance. The clinic also sees patients in consultation for second opinions. Some patients are completely healthy and asymptomatic, with their disease being discovered only on screening mammograms. Others present with locally advanced disease. Patients are of varying socioeconomic status and range widely in age, from teens to octogenarians.
In addition to taking history and physicals in the clinic, Dr. Tran also learns from her attending physicians and Yale’s in-house social worker about how to counsel and support patients coping with the diagnosis of breast cancer. She is learning to perform breast ultrasounds for diagnosis and follow up, as well as ultrasound-guided biopsies of breast lesions. She participates in about 10-15 surgeries per week. She has the opportunity to work with and teach residents and medical students in the operating room, on the wards, and in the clinic.
In her pathology rotation, Dr. Tran learned how to handle and process breast specimens after they leave the operating room. She also spent several hours every morning studying slides under a microscope with a pathologist teaching her how to differentiate cancer from normal breast tissue at a cellular level.
The fellowship program has been very supportive of Dr. Tran’s continuing education by sending her to regional and national conferences to learn the frontier of breast care. She has attended Breast Cancer: Current Controversies and New Horizons at Harvard; and an Ethicon-sponsored program for breast surgery fellows to learn the techniques of ultrasound-guided and stereotactic biopsy. She will attend the Lynn Sage Breast Cancer Symposium in Chicago as a Breast Cancer Achievement Awardee.
A final and very important part of Dr. Tran’s fellowship is participation in research. She was a co-author of a recent presentation at the 90th Annual Meeting of the New England Surgical Society. She has also submitted an abstract to the CT chapter of the American College of Surgeons and has at least two other projects to submit for presentation and/or publication later in her fellowship year.
Dr. Tran grew up in Vietnam and moved to the United States at the age of 11. She holds a BA from the University of California, Berkeley, and an MD from the University of California, San Diego School of Medicine. She completed her residency at the UCSF-Fresno Medical Education Program in the Department of Surgery. She enjoys tennis, ballroom dancing, cooking, traveling, wine tasting, and participating in medical missions.
2009 Memorial Sloan-Kettering Breast Cancer Alliance Breast Surgery Fellow: Jennifer L. Marti, MD
Dr. Jennifer Marti first became interested in breast cancer surgery as a third year medical student, influenced by one of her surgical rotation mentors, who was a breast surgeon. Dr. Marti got involved in clinical research with her mentor, investigating how patients of different ethnic groups presented with breast cancer at New York City’s busy Bellevue Hospital. While in medical school, she was able to present some of her early research projects at the San Antonio Breast Cancer Symposium and the Milan Breast Conference. “These experiences exposed me to the world of breast surgical oncology, in which I have always had a strong interest because of the amount of exciting research being done in this area, and the opportunity to focus on a women’s health issue,” says Dr. Marti.Now she has been on the job as a breast surgery fellow at Memorial Sloan-Kettering Cancer Center (MSKCC) for a few months, and her interest is just as strong. She recounts, “It has been great, an intense experience. I operate with different attending physicians on most days, and spend a day every week with one of them in the clinic. We have a number of multidisciplinary conferences, where we discuss the current literature as it pertains to interesting or difficult cases, as well as other educational conferences. Overall it has been busy but I’ve really been enjoying this opportunity to focus my training.”
During her yearlong breast surgery fellowship, Dr. Marti is focusing on trying to develop a thorough understanding of the vast body of knowledge in breast cancer. She wants to be able to perfect her clinical approach to the workup of a new patient, and also master her surgical technique. As she explains, “The multi-disciplinary approach and care of breast cancer patients is very important, and one of the best parts about this field of surgery, and my fellowship also allows me to spend some time with colleagues in radiation therapy and medical oncology.” Dr. Marti will also be working on a number of clinical research projects, presenting at meetings and writing papers.
She sums up, “I love the fact that MSKCC is a very academic environment, and this is my chance to learn from the world’s leaders in breast cancer surgery. The amount of knowledge and experience my attendings have at their fingertips is tremendous.” Dr. Marti hopes to use the knowledge she gains this year to eventually move on to an academic medical center, as a breast cancer surgical oncologist, a teacher (of medical residents), and a clinical researcher.
Dr. Marti grew up in Michigan. She majored in Biochemistry as an undergraduate at the University of Michigan (Ann Arbor). She then went to New York University School of Medicine, and did her general surgery residency at NYU Medical Center. She enjoys international travel, cooking and spending time in New York City with friends and family.
