An Integrated Multidisciplinary Approach to Breast Cancer: SURG-561

Department: Surgery - Division of Surgical Oncology

Instructor: Eleni A. Tousimis, MD

Contact: Diana Onel

Phone Number: 202-444-8893

Location: Georgetown University

Reporting Time and Place: Visiting students should report to the Office of Surgical Education, Gorman 2051 at 9:30 am the first day of the block. Georgetown students will receive instruction via email and do not need to check in.

Duration: Four Weeks

Max Students: 1 student/ block

Description: The purpose of this course is to provide medical students with an integrated exposure to the multidisciplinary management of breast cancer, to increase one's fund of knowledge of breast cancer, and to improve proficiency in breast cancer risk assessment, and clinical breast exam through a structured teaching program. The students will observe/participate in the clinical management of patients by rotating through the individual specialties involved in breast cancer diagnosis and treatment. The following disciplines will be represented: breast surgery, breast imaging, pathology, radiation medicine, medical oncology, reconstructive surgery, breast cancer genetics, and basic science research. The student will experience an integrated, multidisciplinary approach to breast cancer in the Breast Cancer Consultation Group of the Lombardi Cancer Center, and at the Breast Cancer Conference. The Breast Cancer Consultation Group is composed of a breast surgeon, radiation oncologist and medical oncologist, who meet simultaneously with patients who have been recently diagnosed with breast cancer. The consultation includes a detailed review of all clinically relevant data and breast imaging studies followed by a comprehensive discussion of all aspects of treatment by the three breast cancer specialists. This will provide a unique opportunity for the student to experience the synthesis of issues important to each specialist, and to see how the perspectives of the different specialists are integrated in real-time. This experience will be reinforced by attendance at the weekly Breast Cancer Conference, in which breast cancer cases are presented and discussed by breast cancer specialists from all concerned disciplines. Additional exposure to breast imaging and pathology is also offered by this conference. One day will be spent with a basic science researcher focusing on issues related to genetic alterations/losses/deletions in breast cancer cells and precursor lesions. The schedule is designed to allow for maximal intra- and inter-specialty clinical correlations. Students will have the opportunity to take histories and perform clinical breast examinations on patients in the breast surgery clinic. They will scrub on surgical cases and then see those patients at the time of their post-operative visit. Every attempt will be made to identify a patient in the first week whom the student could follow to diagnostic, consultative, and therapeutic appointments for clinical continuity. Students will complete an ongoing log to document the extent of their exposure to a variety of clinical experiences. Students will participate in a Structured Clinical Instruction Module designed to improve the student's breast cancer knowledge base, ability to use the Gail Model for breast cancer risk assessment, and clinical breast exam proficiency; proficiency will be evaluate via an Objective Structured Clinical Evaluation. The SCIM utilizes video, CD-ROM, breast exam practice on silicone breast models, a Gail Model breast cancer risk assessment calculator, and selected seminal articles, in addition to the clinical component, to accomplish these goals.