Beaumont HospitalProfessional Education

Breast Disease Fellowship, Royal Oak

About

Educational goals

Breast surgery

  • physician should demonstrate proficiency in patient selection, evaluation and operative management of common benign and malignant breast conditions.
  • appropriately identify the indications and techniques of palliative surgical procedures
  • demonstrate knowledge in evolving percutaneous ablative technologies
  • proficiency in the performance and interpretation of the results of common in-office procedures
  • evaluation and management of arm lymphedema resulting from breast cancer treatment

Breast imaging

  • understand the techniques and nomenclature of diagnostic mammography
  • recognize the characteristics of benign and malignant lesions,
  • proficiency in the performance of breast sonography and image guided biopsies
  • evaluate and appropriately utilize magnetic resonance imaging in the evaluation of breast disease
  • recommend and interpret techniques of breast lymphoscintigraphy

Medical oncology

  • assess the indications and contraindications for adjuvant systemic chemotherapy and endocrine therapies
  • understand the mechanisms of action, risks, benefits, side effects, acute and chronic toxicities of these treatments
  • understand the management of recurrent and metastatic disease including palliative care

Radiation oncology

  • understand the processes of
    • simulation
    • treatment planning
    • treatment delivery
  • acute and chronic effects of radiation therapy
  • understand the indications and contraindications for radiation therapy following breast conserving surgery
  • demonstrate proficiency in the use of the common DCIS scoring systems and understand the controversies regarding the use of radiation therapy in the management of women with DCIS
  • sequencing of multimodal therapy in both the neoadjuvant and adjuvant settings for the treatment of women with invasive cancer
  • understand the techniques, indications and limitations of breast brachytherapy, breath holding techniques and intensity modulated radiation therapy (IMRT)

Pathology

  • recognize common benign and malignant pathologic features of breast disease
  • understand formal techniques for marking, processing and assessing the pathology specimen as well as the use of immunohistochemical stains, cytology, tumor markers and other indicators of prognosis

Plastic and reconstructive surgery

  • demonstrate an understanding of the techniques for immediate and delayed reconstruction in the setting of post mastectomy reconstructive surgery, oncoplastic techniques used in breast conservation
  • general breast aesthetic procedures such as augmentation and reduction

Genetics

  • able to identify patients at high risk for developing breast cancer including risk factors such as pathologic, familial, genetic and previous cancer-inducing therapies as well as life style and environmental factors
  • use contemporary risk assessment models and advise patients on risk reduction behavior by screening, medication and surgery
  • take a detailed family pedigree and history, and advise patients regarding the indications, usefulness, cost, complications and privacy issues of genetic testing

Patient advocacy

  • able to recognize the needs of patients and their families with regard to illness and treatment with appropriate attention to existing social support systems and cultural diversity
  • participate in existing support groups, and identify local support and advocacy organizations to serve as a physician-patient liaison

Residency Programs

Fellowship Programs

Fellowship Programs
(no ACGME accreditation)


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