1. GENERAL

The modern management of breast disease requires an in-depth knowledge of not only surgery, but breast imaging, image-directed biopsy techniques, pathology, radiation oncology and medical oncology. This fellowship is designed to enhance the basic knowledge of the management of breast disease acquired by a general surgical trainee, particularly in the nonsurgical disciplines.

Successful completion of a 5-year accredited program in general surgery is a prerequisite.

2. OBJECTIVES

The breast fellowship will enable the resident to acquire an advanced body of knowledge and level of skill in the management of breast disease in order to assume a leadership role in teaching and research in the field.

This will include:

1. an understanding of the classification and evaluation of mammographic abnormalities;
2. knowledge of the indications, techniques and complications of image-guided breast biopsy;
3. understanding of the basic techniques of gross breast specimen evaluation and processing,
   recognition of basic breast pathology and knowledge of pathologic prognostic factors;
4. ability to counsel patients on treatment options for the local therapy of breast cancer;
5. evaluation of breast problems in an office-based setting;
6. understanding the indications, complications, techniques, results and biology of breast irradiation;
7. understanding the indications, results and basic biology of systemic therapy for breast cancer; and
8. understanding the biology, evaluation and treatment of benign breast disease.
   
   

In addition, individuals completing this training program will be able to:

1. Evaluate the clinical literature in breast disease critically and contribute to the field.
2. Teach the specialty of breast disease.
3. Organize a multidisciplinary approach to breast cancer care.

3. CURRICULUM

1. Knowledge Base
   • 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
   • Selection of local therapy, contraindications, local recurrence, expected outcomes
   • Radiation therapy postmastectomy and as part of breast conservation
   • Adjuvant systemic chemotherapy and endocrine therapy
   • Preoperative workup and postoperative monitoring
   • Psychological and legal aspects of breast cancer care
2. Skills
   • Stereotactic or ultrasound-guided core biopsy
   • Cosmetic breast-conserving surgery or biopsy
   • Skin-sparing mastectomy
   • Axillary dissection with intercostobrachial nerve preservation
   • Interpretation of mammograms and ultrasound
   • Sentinel node biopsy

4. ORGANIZATION AND FACULTY

• Program Director - The program will be directed by Monica Morrow, MD, Director of the Lynn Sage Comprehensive Breast Program
• The program will be in the Department of Surgery and the Division of Surgical Oncology
• Faculty
  1. The primary surgical faculty for the program will be Dr. Monica Morrow, Dr. Seema Khan and Dr. Valerie Staradub.
  2. The participating surgical faculty at Evanston Hospital will be Dr. David P. Winchester, Dr. Stephen Sener and Dr. David J. Winchester.
  3. Supervision of the fellow in nonsurgical disciplines will be the responsibility of the individual in that section designated as the leader in the breast cancer efforts in mammography, pathology, radiation oncology and medical oncology.

5. RELATIONSHIP TO GENERAL SURGERY RESIDENCY

The fellow will not be responsible for the supervision of general surgery residents.
Six months of the fellowship will be spent on nonsurgical rotations. The integrity of the general surgery residency will be maintained during the months of surgical rotation (four months at Northwestern Memorial Hospital, two months at Evanston Hospital) by scheduling fellows and general surgery chief residents to cover different attendings. For example, four surgical attendings practice in the breast center. The fellow will spend two months with two attendings and two months with two other attendings. During each of these blocks, two other office practices will be available to the general surgery chief resident. At present, more than 600 primary breast cancers are treated at each of the institutions participating in the fellowship. Many of these cases are done by attending staff due to lack of appropriate resident coverage, so the participation of the fellow in selected cases will not make an impact on the operative experience of the general surgery residents.

6. APPLICATION AND SELECTION PROCESS

Written application, including a copy of the candidate's curriculum vitae and letters of recommendation, will be solicited.

Appropriate candidates will be interviewed by Dr. Morrow and other participating surgical faculty.

Applicants will be selected by faculty committee based on past record of achievement, recommendations and the interview process without regard to gender or race.

7. EVALUATION

Residents will be evaluated by participating faculty for each of the rotations in the program. In addition to an overall evaluation, faculty will assess whether the resident has met the goals for curriculum and skills acquisition.

The program director and executive committee will meet with the resident at three months, six months and 11 months to provide performance feedback.

Successful completion of the program will be contingent upon meeting curricular and skills requirements as judged by evaluations. In addition, the trainee must (1) complete at least one scholarly project suitable for publication, (2) make one local presentation and (3) show evidence of teaching medical students and residents.

8. ADMINISTRATIVE STRUCTURE

The fellowship will be part of the McGaw Medical Center Graduate Medical Education Program. All policies of the McGaw Medical Center GME Program will apply to the fellowship, fellows and faculty.

Fellows will be recommended for appointment to the faculty of Northwestern University at the level of Clinical Instructor in Surgery. Any faculty appointment will be co-terminous with the duration of the fellowship.

We are offering one-year fellowship positions for July 1, 2002 -2003 at the Lynn Sage Comprehensive Breast Center of Northwestern Memorial Hospital. The Center provides all-inclusive care for the patient with breast disease. Our fellowship program provides extensive training in film-screen and full-field digital mammography, breast ultrasound and interventional techniques including stereotactic and ultrasound-guided needle biopsies, sentinel lymph node mapping and ductography. Nearly 40,000 breast imaging exams and procedures were performed in 2000 with continued annual growth.

The program also includes rotations in breast surgery, pathology and radiation oncology to ensure that the fellows gain experience in these closely related specialties. Attendance at the weekly multidisciplinary breast conference provides a comprehensive clinical perspective on breast cancer care. In addition, the fellows will have an opportunity to participate in ongoing research projects including full-field digital mammography and breast MRI.

We are currently accepting applications and will be conducting personal interviews. Applicants should be board-certified or board-eligible in diagnostic radiology.

Ellen Mendelson, MD
Director, Section of Breast Imaging
Northwestern Memorial Hospital
Lynn Sage Comprehensive Breast Center
Galter Pavilion, Rm. 13-136
675 N. St. Clair
Chicago, IL 60611

OVERVIEW

The Robert H Lurie Comprehensive Cancer Center has made significant advances in establishing a premier Breast Cancer Research Program at Northwestern University. The Training Program in the Molecular Biology of Breast Neoplasia enables four predoctoral students and two postdoctoral fellows per year to receive state-of-the-art training in breast cancer biology, utilizing the tools of molecular biology, genetics and biochemistry to study the complex process of breast neoplasia. Trainees participate in a weekly Journal Club, a multidisciplinary course in breast cancer and monthly breast cancer research meetings. The preceptors of this program are well-established investigators with NIH-funded research programs.

Program Director:
V Craig Jordan, PhD, DSc
Diana Princess of Wales Professor of Cancer Research
Robert H Lurie Comprehensive Cancer Center

Administrative Director:
Robin Leikin, PhD
Research Assistant Professor
Robert H Lurie Comprehensive Cancer Center

The Robert H Lurie Comprehensive Cancer Center is an NCI-funded cancer center. The Cancer Center Director is Steven T Rosen, MD, FACP, Professor of Medicine.

Predoctoral students must be enrolled in a graduate program (IGP or IBiS) at Northwestern University. Postdoctoral fellows must have received their PhD within the last two years.

Applicants should send their curriculum vitae, statement of research interests, selection of two potential mentors from Program Faculty and two letters of reference to:

Robin Leikin, PhD
Robert H Lurie Comprehensive Cancer Center
Northwestern University
303 E. Chicago Avenue
Chicago, IL 60611
(312) 908-9229

INTRODUCTION

The Robert H Lurie Comprehensive Cancer Center of Northwestern University is an NCI-funded cancer center. The Clinical Oncology Research Training Program at the Cancer Center enables four postdoctoral fellows per year to receive state-of- the-art training in one of four areas:

1. viral carcinogenesis
2. tumor invasion, metastasis and angiogenesis
3. hormones and signal transduction in cancer
4. cancer genes and molecular regulation
   

Trainees have the opportunity to carry out laboratory research as well as to explore the applied relevance of their research. The laboratory preceptors of this program are well-established investigators with NIH-funded research programs. A structured educational curriculum, clinical rotations and seminar series complement the laboratory training.

Program Director:
Steven T Rosen, MD,
Professor and Director
Robert H Lurie Comprehensive Cancer Center

Program Co-Director:
Leo I Gordon, MD
Professor, Department of Medicine
Chief, Division of Hematology/Oncology

Program Co-Director:
Sharon Murphy, MD
Professor, Department of Pediatrics
Chief, Division of Hematology/Oncology

Administrative Director:
Robin Leikin, PhD
Research Assistant Professor
Robert H Lurie Comprehensive Cancer Center

PROGRAM OVERVIEW

The Clinical Oncology Research Training Program of the Robert H Lurie Comprehensive Cancer Center offers two years of laboratory research through the adult or pediatric divisions of Hematology/Oncology. Second- or third - year fellows enrolled in accredited programs in adult or pediatric hematology/oncology interested in laboratory research can apply to the Cancer Center’s NCI-funded training program, the Clinical Oncology Research Training Program. Both a basic science faculty member and a clinical science mentor supervise fellows selected into the program.

CURRICULUM

• Laboratory research (80% effort)
• Coursework in Tumor Cell Biology and Carcinogenesis
• Weekly Laboratory Journal Club meeting
• Biweekly Oncology Research Journal Club
• Monthly meeting with clinical mentor
• Annual translational research retreat
• Annual research presentation
• Quarterly basic science symposia and minisymposia
• Colloquium on ethics in biomedical research
• Outpatient clinic one day per week

CLINICAL MENTORS

Al Benson, MD
Richard Burt, MD
Peter Gann, MD
Leo Gordon, MD
Bill Gradishar, MD
Morris Kletzel, MD
Timothy Kuzel, MD
Hau Kwaan, MD
Sharon Murphy, MD
Martin Tallman, MD
Jamie Von Roenn, MD
Jane Winter, MD

LABORATORY PRECEPTORS

Fellows select a laboratory research mentor from the following faculty listed by their Cancer Center program affiliation.

Applicants must be U.S. citizens or permanent residents who are completing their residency or who have completed one year in an accredited fellowship program.

For additional information about the Division of Hematology/Oncology

For additional information about the laboratory preceptors

Applicants should send their curriculum vitae, medical school transcripts, statement of research interests, list of three potential mentors and three letters of reference to:

Robin Leikin, PhD
Robert H Lurie Comprehensive
Cancer Center
Northwestern University
303 E. Chicago Avenue
Chicago, IL 60611

funded by the
National Cancer Institute
National Institutes of Health