DO surgical oncologist specializes in caring for patients who have breast cancer

In the wise words of former First Lady Nancy Reagan, “Time is short, and life is precious.” In 1987, Mrs. Reagan was found to have an early-stage breast cancer. She eventually chose to have a modified radical mastectomy.

Physicians who specialize in surgical oncology help people who have been diagnosed with breast cancer navigate treatment and surgical options, including mastectomy. These specialized physicians such as Sadia Khan, DO, undergo intense training. During Breast Cancer Awareness Month in October, we talk to Dr. Khan about her journey in medicine.

Dr. Khan is AOA board certified in general surgery and currently serves as a surgical oncologist in Newport Beach, California. She is also an assistant clinical professor of surgery at Keck School of Medicine of the University of Southern California (USC), as well as the director of integrative breast oncology at the Hoag Breast Center in Newport Beach.

Her areas of expertise include oncoplastic surgery, extreme oncoplasty and intraoperative radiation therapy techniques, and she works closely with young and high-risk patients and also provides compassionate care for those with all breast diseases. Following is an edited Q&A with Dr. Khan.

Tell us a little about your path to medicine and a little bit about yourself.

I am a breast surgical oncologist and director at the Hoag Breast Center in Newport Beach. I also serve as an associate program director for the USC breast fellowship program. I completed five years of general surgery training at Arrowhead Regional Medical Center and went on to do my breast fellowship at USC. I love what I do and am passionate about advocating for the best care for my patients.

My cultural background is Pakistani, and I grew up in Houston. Since I can remember, I have always wanted to be a doctor and help others. I was inspired by my pediatrician, who was a strong Pakistani female physician who was smart, successful and always caring and empathetic.

What specifically brought you to surgical oncology?

I love that breast surgery is such a wonderful specialty where surgeons can connect with and form long-term relationships with their patients. It’s meaningful to make a difference and help coordinate care on a multispecialty care team.

What obstacles did you face entering the surgical field?

There is a stigma associated with entering a surgical specialty, which has some truths to it. General surgery residencies often have grueling schedules, very high expectations and high-stress patient care situations that quite literally involve making life-or-death decisions. It was not an easy specialty to decide on, but I realized after my surgical rotation that I had a passion for it.

What advice would you give to medical students on choosing a specialty?

Students should try to expose themselves to as many specialties as they can in medical rotations, and even seek out other shadowing opportunities. Finding a specialty that you are passionate about is the most important thing. Work-life balance is a potential issue with surgical specialties, but I think if you find what you are good at and happy doing, you can find a job that gives you the best of both worlds.

You have recent publications in surgical oncology. What are your current areas of interest and what led you to pursue research outside of teaching and your own clinic?

I love being able to lead and contribute to best practices and help improve breast cancer care as we know it. Participating in clinical research and presenting our work has given me a way to keep my practice up to date and interesting. Most of my clinical research interests are focused around oncoplastic breast surgery and intraoperative radiation therapy. You can read one of my recent research articles on the National Library of Medicine’s website.

Are there any new surgical oncology breakthroughs in research up and coming?

Breast surgery is a rapidly evolving field. Most of what I learned in residency is already antiquated. The overall theme of treatment patterns is “de-escalating therapy” or finding effective treatment options for patients without over-treating. Examples of de-escalation are doing less surgery, less radiation and less chemotherapy, but with the same cancer outcomes. The ACOSOG Z0011 trial changed how we treat positive axillary sentinel lymph nodes in breast cancer.

October is Breast Cancer Awareness Month. Can you share with us some basic information about breast cancer that physicians can share with their patients?

One in eight women in the United States will develop breast cancer at some point in their life. We are seeing many women in their 30s and 40s being diagnosed. The most important thing we need to do is educate women to be aware and notify their physicians of any changes they see or feel in their breast: lumps, bumps, dimpling, discharge, skin changes, etc.

Patients should start mammograms at 40 years old and, in some cases, some women may need imaging even earlier. Each person’s risk is individual, so often a baseline mammogram at 35 can be done and then yearly imaging at age 40. Roughly 90 to 95% of breast cancer cases are not hereditary, so just because someone doesn’t have a family history of breast cancer, does not mean they shouldn’t do adequate screening.

What are common signs and symptoms patients should be watching for?

Patients should evaluate their breasts for what is “normal” for them so if a change occurs, they can notify their physician. They should look for new changes, new lumps, nipple inversion, spontaneous nipple discharge, skin indentations, redness of the skin or nipple that doesn’t go away, etc.

What resources can physicians share with cancer patients and cancer survivors?

There are many reputable free websites with good basic information about breast cancer including: breast360.org (through the American Society of Breast Surgeons), The American Cancer Society website and Susan G. Komen. Many hospitals and health care facilities also have survivorship resources.

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