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Curriculum

Clinical Training
The Multidisciplinary Breast Surgery Fellowship will enable the fellow to acquire an advanced body of knowledge and a level of skill in the management of breast disease in order to assume a leadership role in a clinical, academic teaching or research facility in the field. This will include:

  • Evaluation and management of benign breast disease
  • Breast cancer risk assessment
  • Breast cancer genetics
  • Screening and diagnostic mammography
  • Natural history and pathology of benign and malignant breast disease
  • Proficiency in interdisciplinary evaluation and pre-surgical treatment planning
  • Selection of local therapy, indications, local recurrence, expected outcomes
  • Radiation therapy post mastectomy and as part of breast conservation
  • Adjuvant systemic chemotherapy and endocrine therapy
  • Preoperative work-up and postoperative care
  • Management of surgical complications related to breast surgery
  • Reconstructive options following mastectomy and breast conserving treatment with poor cosmesis
  • Evaluate and manage arm lymphedema
  • Psychosocial and legal aspects of breast cancer care

The following procedural skills will be acquired during your training:

  • Interpretation of mammograms and ultrasound
  • Stereotactic or ultrasound guided core biopsy
  • Subareolar duct excision
  • Intraoperative ultrasound
  • Cosmetic breast conserving surgery or biopsy
  • Modified radical mastectomy
  • Skin-sparing mastectomy
  • Axillary dissection
  • Sentinel node biopsy

Didactic Training
Your training will include surgery conferences and other clinical conferences in the departments of surgery, internal medicine, oncology and the breast clinic. These include:

  • Weekly Surgery Department Grand Rounds and Morbidity/Mortality Conference
  • Weekly Multidisciplinary Breast Care Conference
  • Attendance at Oncology Core Curriculum lectures
  • Monthly Journal Club
  • Opportunity to participate in cadaveric anatomic dissections in Procedural Skills Lab

The Division of Surgery participates in the evidence-based medicine program, case conferences and visiting faculty conferences. All didactic courses are open to both residency program members and fellows in all subspecialties.

Research Training
The optional research component of the fellowship includes the use of clinical epidemiological techniques and population databases to develop research protocols, the organization and completion of at least one clinical research project, and formal training in medical research methodologies.

Mayo Clinic is committed to ongoing research in the diagnosis and treatment of benign and malignant breast diseases. Mayo Clinic physicians currently are studying, among other things:

  • Detection of circulating cancer cells for early diagnosis of breast cancer
  • Tamoxifen and raloxifene as a prevention for breast cancer
  • Therapies for metastatic breast cancer
  • Bone marrow analysis in breast cancer
  • Ginkgo biloba for prevention of chemotherapy-related cognitive dysfunction
  • The effects of exercise and sleep training on the fatigue of cancer patients receiving radiation
  • Breast imaging using MRI
  • Mammographic breast density
  • Alternative medicine for various breast conditions
  • MR-guided focused ultrasound ablation breast cancer
  • Use of a radioactive seed for localization of nonpalpable breast lesions
  • Benign breast disease and subsequent breast cancer risk
  • Prediction models for nonsentinel node disease in patients with a positive sentinel node
  • Outcomes with inflammatory breast cancer
  • BRCA gene mutations of unspecified clinical significance

In addition, the Women's Cancer Program of the Mayo Clinic Cancer Center is conducting a national research study on potential biomarkers that indicate which women with benign breast disease are at risk for eventually developing breast cancer. Funded by a Breast Cancer Center of Excellence grant from the Department of Defense Breast Cancer Research Program, this four-year study will look for molecular risk predictors in benign breast tissue.

The study will draw upon tissue specimens taken from 12,000 women who had breast biopsies performed at Mayo Clinic between 1967 and 1991, and were found to have benign breast disease.

Evaluation

To ensure you gain proficiency and develop the corresponding technical skills, your performance is monitored throughout this program. You are formally evaluated by your supervising faculty member following the completion of each clinical rotation; and then meet accordingly with the program director to review these evaluations. In addition, you regularly evaluate the faculty to ensure your educational goals are being met.

  • ART283776