Breast Rotation
Residents will rotate with Drs. Patel and Howard to evaluate adult patients with breast neoplasms. Patients will be seen primarily in a multidisciplinary context, together with surgeons, medical oncologists, radiologists, pathologists and other support personnel as indicated. Patients will be seen and evaluated as inpatients both at UW Hospital and Meriter Hospital. The rotation will provide opportunities in enhancing the multidisciplinary knowledge in the management of breast cancer. In addition, since a proportion of these patients are treated with advanced radiotherapy techniques such as 3-D radiotherapy and brachytherapy, residents will have ample opportunity, and are highly encouraged, to become proficient in the application of these technologies. In order to truly appreciate the multidisciplinary management of these patients, several patients with new breast cancer diagnosis seen at UWH are discussed at the weekly combined modality Breast Conference, attendance at which is required.
Typically, in an average 3-month rotation, residents will have contact with approximately 50-80 new breast cancer patients, and over 80 follow-up contact opportunities. In addition, in an average 3-month time span, residents will have the opportunity to participate in over 20 brachytherapy procedures.
Goals and Objectives
Observe and understand the etiology, epidemiology, molecular genetics, pathophysiology, clinical presentation, natural history, treatment options, risks and benefits of various options and long-term sequalae of treatment for patients with breast cancer. Understand the educational, social, societal, quality of life and cost-effectiveness issues surrounding the management of the above patients. Understand the multimodality approaches to these conditions, and learn an appropriate physician behavior pattern that optimizes multidisciplinary interaction. Become proficient in the technical aspects of radiotherapeutic management of breast cancer, including routine radiotherapy, as well as specialized applications such as brachytherapy, virtual simulation, 3-D planning, complex multi-field set-ups, IMRT (once implemented) and Tomotherapy (once implemented). It is also expected that a basic foundation in the radiobiologic concepts underpinning these approaches will be developed. Become proficient in the application of palliative radiation therapy techniques, including, but not limited to bone and brain metastases, cord-compression, cauda-equina syndromes, nerve root entrapment syndromes, etc. Understand the relative merits and application of other palliative modalities in this context. Learn to make appropriate decisions regarding resource utilization for these patients. Learn the value of and utilize Hospice services appropriately for such patients. Understand and appreciate the opportunities for clinical and translational research in this patient population.