Breast Oncology Fellowship

Interim Program Director: Dennis Holmes, MD, FASC.

The John Wayne Cancer Institute (JWCI) at Providence Saint John's Health Center (PSJHC) offers a one-year SSO accredited breast oncology fellowship emphasizing comprehensive management of benign and malignant breast disease, guided by compassion and attention to continuity of care and the patient’s perception. An optional second year is available for breast oncology research.

During the clinical fellowship, the breast fellow is trained to evaluate and manage benign and malignant breast conditions, interact with specialists from many disciplines, and evaluate and participate in clinical and translational research. The multidisciplinary program covers overall breast health, risk factors, epidemiology, early detection, prevention, cancer treatment, wellness, survivorship and quality of life.  The program also fosters development of leadership skills necessary to initiate and run a successful program in clinical and translational breast oncology. Didactic sessions, including basic science and clinical specialty research seminars, complement all aspects of the program.

Rotations

The one-year curriculum consists of eight months of breast surgery and four months of core rotations. The fellow spends six months on the breast service at the Margie Petersen Breast Center at Providence Saint John’s and two months at Kaiser Permanente Los Angeles Medical Center.  During the surgical rotation, emphasis is placed on operative techniques unique to breast oncology and the development of clinical judgment in managing difficult cancer problems, as well as a strong foundation in benign diseases. The fellow alternates daily between the outpatient clinic and the operating room where he/she receives training in state-of-the-art surgical procedures including sentinel lymph node biopsy techniques, oncoplastic surgery, nipple-sparing mastectomy, and minimally invasive diagnostic and therapeutic procedures (image-guided biopsies, cryoablation). Previous breast fellows have averaged approximately 350 breast surgical cases per year.

Core rotations include medical oncology, radiation oncology, surgical pathology and breast imaging.  Each of these one-month core rotations is staffed by experts in the field and has specific learning objectives, skill requirements, and problem-solving sessions. All core rotations are completed at the Margie Petersen Breast Center at Providence Saint John’s.  Adjunct rotations in community outreach, genetics, plastic surgery, survivorship, palliative care and clinical research are completed at Providence Saint John’s and Kaiser Permanente. 

During core and adjunct rotations, the breast fellow is responsible for all new patient histories and physical examinations, preoperative workup, management decisions, treatment interventions, inpatient care of postoperative patients, research questions, and participation in clinical research protocols. The fellow presents all newly diagnosed patients or patients with recurrent disease at Breast Multidisciplinary Tumor Board or at Pre-Operative Teaching Conference. In addition to participating in clinical research projects, the fellow may initiate his/her own projects and write grants.

Faculty and Facilities

Considered one of the nation’s top breast facilities, the Margie Petersen Breast Center at Providence Saint John’s is affiliated with the internationally acclaimed John Wayne Cancer Institute and offers patients a comprehensive approach to diagnosing and treating breast disease with state-of-the-art technology. Care focuses on the whole person through innovative programs such as cryoablation, psychological care, wellness, nutrition, education and prevention. The Margie Petersen Breast Center houses six high-resolution digital mammography units, a magnetic resonance imaging unit with a dedicated breast coil, ultrasound equipment, and a dedicated prone stereotactic core biopsy device and busy outpatient clinic. Each year the Center evaluates more than 800 new patients. The Institute acts as a tertiary referral center for a regional population of 14 million people and receives nationwide and international referrals from 48 states and 30 foreign countries.

The multidisciplinary breast service at Kaiser Permanente Los Angeles Medical Center includes 2 breast fellowship-trained surgeons, 2 surgical oncologists, a medical oncologist, a radiation oncologist, a pathologist, a radiologist, 2 genetic counselors and a social worker.

Presentations, Papers, and Grants

Participation in clinical research projects, publications and presentations is expected, and fellows receive guidance in scientific writing for preparation of research protocols, grant proposals, and journal papers. They are taught how to prepare their study results for submission to peer-reviewed medical/scientific journals, and how to review and evaluate scientific publications.  They also are expected to present their research findings at national meetings. Recently graduated fellows have presented their work at the SSO Annual Symposium, ACS Southern California Chapter, Pacific Coast Surgical Association and ASCO.

Eligibility

The applicant must be a U.S. citizen or permanent resident who has completed a surgical residency, is board-eligible or board-certified in general surgery, and is eligible for a California medical license. Salary, fringe benefits, and malpractice insurance are provided. http://www.surgonc.org/training-education/breast-oncology  

Contacts and Addresses

Fellowship Coordinator: Rebecca Bernstein
Address: John Wayne Cancer Institute
2200 Santa Monica Blvd
Santa Monica, CA 90404
Phone: 310-998-3989
Fax: 310-582-7185
Email: bernsteinr@jwci.org