Making surgical education intuitive: A surgical robotics primer for pre-clinical medical students.

Background: As robotic surgeries increase nationwide, residency programs are implementing commensurate curriculum. Medical student exposure and comfort with these surgeries, however, is lagging. This program sought to improve student interest and confidence through additional robotic exposure.

Holding the Knife on Perceptions of Surgery.

Objective: Negative stereotypes associated with surgery by medical students are well documented in literature. Many cite long hours, poor work-life balance, pessimism, mean personalities, and cynicism as pervasive among surgeons and operating room culture. If allowed to persist, these negative perceptions can deter otherwise interested students from pursuing surgical subspecialties.

Interactive multidisciplinary pilot workshop to improve medical student perception of and interest in breast surgical oncology.

Background: Exposure to breast surgical oncology (BSO) and the multidisciplinary management of patients with breast cancer is limited in medical school. The purpose of this study was to assess changes in student perceptions of BSO as a career following an interactive multidisciplinary workshop.

Methods: Pre-clinical medical students participated in a multidisciplinary, hands-on workshop, composed of breast radiology (BR), breast surgical oncology (BSO) and breast plastic reconstructive surgery (B-PRS).

Clinical and Biomarker Findings of Neoadjuvant Pembrolizumab and Carboplatin Plus Docetaxel in Triple-Negative Breast Cancer: NeoPACT Phase 2 Clinical Trial.

Importance: Addition of pembrolizumab to anthracycline-based chemotherapy improves pathologic complete response (pCR) and event-free survival (EFS) in triple-negative breast cancer (TNBC). The efficacy of anthracycline-free chemoimmunotherapy in TNBC has not been assessed.

Objective: To assess the efficacy of the anthracycline-free neoadjuvant regimen of carboplatin and docetaxel plus pembrolizumab in TNBC.

Evaluation of learning curve with Indocyanine Green (IcG) versus blue dye for sentinel lymph node biopsy in breast cancer.

Background: Indocyanine green (IcG) is an alternative to isosulfan blue (IB) for sentinel lymph node (SLN) mapping in breast cancer (BC). IcG carries improved cost and safety, but oncologic data upon implementation in practice is limited. We evaluated the learning curve defined as oncologic yield and operative (OR) time for IcG in SLN mapping in BC.

Impact of Clinical Anatomy Peer Mentorship Program on Student Leaders: A Mixed-Methods Study.

Introduction: Clinical Anatomy Mentorship Program (CAMP) was developed as a student-led approach to providing hands-on surgical experience and mentorship to third-year medical students during their surgery clerkship at an academic institution. Fourth-year medical students were selected to lead these educational events, teaching underclassmen surgical curriculum and skills in a near-peer method of clinical teaching.

Methods: A focus group and survey were administered to the fourth-year medical students who served as CAMP leaders from fall 2021 to spring 2022 to assess how their leadership role impacted their personal and professional development.

Breast Cancer-Related Lymphedema (BCRL) and Bioimpedance Spectroscopy: Long-Term Follow-Up, Surveillance Recommendations, and Multidisciplinary Risk Factors.

Background: Early detection and intervention for breast cancer-related lymphedema (BCRL) significantly decreases progression to persistent BCRL (pBCRL). We aimed to provide long-term follow-up on our early detection with bioimpedance spectroscopy (BIS) and early home intervention demonstrating reduced pBCRL to guide surveillance recommendations.

Patients And Methods: In total, 148 female patients with breast cancer who had axillary lymph node dissection (ALND) from November 2014 to December 2017 were analyzed.

Advanced degrees, gender, and professional rank in surgery, disparities in academic medicine.

Introduction: Women comprise nearly half of all residents in training, yet there is a significant disparity of women in academic leadership. Surgical subspecialties are dominated by men in both percentages of physicians and leadership positions. We sought to examine the association of advanced non-medical degrees with academic rank and gender in academic surgery departments.

Building Approachable Surgical Experiences (BASE) in High School Populations.

Objective: Pipeline programs are often set up to bring more diverse candidates to medical schools with the goal of diversifying the physician workforce in the years to come. All too often, these programs begin in college, long after many students of diverse backgrounds have been left behind through a myriad of barriers that exist between entering high school and matriculating to medical school. The Building Approachable Surgical Experiences (BASE) outreach program was designed to showcase healthcare careers, with an emphasis on surgical subspecialties, to historically underserved high school students.

Oncoplastic Breast Reconstruction for Large Pediatric Breast Tumors: A Case Series.

Large breast fibroadenomas in pediatric females may cause discomfort, asymmetry, and psychological stress, and patients may elect for surgical excision. There are no criteria for reconstruction after the excision of these masses, and the research is limited in describing oncoplastic techniques in pediatric fibroadenoma excision. Nononcoplastic techniques, such as mastectomy with implant or flap reconstruction, have been used for pediatric fibroadenoma excision reconstruction.

A Hands-On Surgical Event to Improve Medical Student Operating Room Confidence.

Introduction: The negative perceptions and lack of exposure to surgery and the operating room (OR) have been known to divert students away from surgical specialties. This study describes the impact of a surgical subspecialty exposure event (OR Essentials), combined with surgical faculty and M4 mentorship on preclinical medical students' confidence at an academic medical center.

Methods: OR essentials event teaches surgical skills to preclinical medical students through hands-on skill-based workshops in a simulated OR setting.

Improving Medical Student Anatomy Knowledge and Confidence for the Breast Surgical Oncology Rotation.

Background: The anatomy curriculum has undergone considerable reductions in class time, resulting in decreased student anatomical knowledge retention and confidence during their surgical rotations. To counter this deficit in anatomy knowledge, a clinical anatomy mentorship program (CAMP) was developed by fourth-year medical student leaders and staff mentors in a near-peer teaching fashion prior to the surgical clerkship. This study analyzed the impact this program had on third-year medical students (MS3s) self-assessed anatomical knowledge and confidence in the operating room on the Breast Surgical Oncology rotation after this near-peer program.

Use of Ultrasound and Ki-67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy.

Background: Prediction of tumor shrinkage and pattern of treatment response following neoadjuvant endocrine therapy (NET) for estrogen receptor positive (ER+), Her2 negative (Her2-) breast cancers have had limited assessment. We examined if ultrasound (US) and Ki-67 could predict the pathologic response to treatment with NET and how the pattern of response may impact surgical planning.

Methods: A total of 103 postmenopausal women with ER+, HER2- breast cancer enrolled on the FELINE trial had Ki-67 obtained at baseline, day 14, and surgical pathology.

Safety of de-escalation of surgical intervention for atypical ductal hyperplasia on percutaneous biopsy: One size does not fit all.

Background: Oncologic safety of active monitoring (AM) for atypical ductal hyperplasia (ADH) on core-needle biopsy (CNB) is not well defined. We sought to define oncologic outcomes for AM to manage ADH meeting institutional predefined low-risk criteria (LOW).

Methods: ADH was diagnosed on CNB from 10/2015-03/2020.

Rethinking Routine Surgical Excision for all Radial Sclerosing Lesions of the Breast.

Introduction: The need for routine surgical excision of a radial sclerosing lesions (RSL) of the breast identified on percutaneous biopsy remains controversial, as contemporary upgrade rates are lower than historically cited.

Materials And Methods: A prospectively-maintained database of high-risk breast biopsies undergoing multidisciplinary review at a single institution was queried to identify cases of RSL from 2/2015 to 11/2020. Demographic, radiologic, and pathologic variables were summarized using frequencies and analyzed in association with RSL excision status using mixed-effects logistic regression or Fisher's exact tests.

The clinical impact of MRI on surgical planning for patients with in-breast tumor recurrence.

Objective: The objective of this study was to evaluate the clinical utility of breast MRI for patients with known in-breast tumor recurrence (IBTR). The aim was to determine if the addition of breast MRI altered surgical approach or multidisciplinary management. Previous studies have focused on using breast MRI for surgical planning for index breast cancers (BC) or detecting IBTR.

Multidisciplinary Review of Intraductal Papilloma of the Breast can Identify Patients who may Omit Surgical Excision.

Background: The purpose of this study was to define contemporary management recommendations regarding who would benefit from surgical excision of intraductal papilloma (IDP).

Methods: A prospective database from a single institution identified patients with IDP on percutaneous biopsy from February 2015 to September 2020. Categorical patient demographic, biopsy, and pathologic variables were analyzed using Fisher's exact test and continuous demographic and imaging variables using the Mann-Whitney U test.

Impact of the early COVID-19 pandemic on Breast Surgical Oncology fellow education.

Introduction: The early COVID-19 pandemic rapidly transformed healthcare and medical education. We sought to evaluate the professional and personal impact of the pandemic on 2019-2020 Breast Surgical Oncology (BSO) fellows in Society of Surgical Oncology approved programs to capture the experience and direct future changes.

Methods: From July 15, 2020 to August 4, 2020 a survey was administered to the American Society of Breast Surgeons' fellow members.

Risk of Breast Cancer in Selected Women With Atypical Ductal Hyperplasia Who do not Undergo Surgical Excision.

Objective: To review breast cancer incidence in women with ADH diagnosed by CNB and managed nonoperatively.

Background: ADH found on CNB is associated with an upgrade to carcinoma in 10%-50% of women, thus surgical excision remains the standard of care. Safety of nonoperative management is unknown.

Reducing Breast Cancer-Related Lymphedema (BCRL) Through Prospective Surveillance Monitoring Using Bioimpedance Spectroscopy (BIS) and Patient Directed Self-Interventions.

Background: Breast cancer-related lymphedema (BCRL) is a chronic progressive disease that results from breast cancer treatment and nodal surgery. NCCN guidelines support baseline measurements with prospective assessment for early diagnosis and treatment. We sought to determine if baseline measurement with bioimpedance spectroscopy (BIS) and serial postoperative evaluations provide early detection amenable to conservative interventions that reduce BCRL.

Have We Come as Far as We Had Hoped? Discrimination in the Residency Interview.

Objective: The primary objective was to use a pilot survey of fourth-year medical students at our institution to determine if female residency applicants were asked potentially illegal questions regarding family status and childbearing more frequently than male applicants. Secondary objectives included comparing the use of potentially illegal questions in surgical versus nonsurgical specialties and between community and academic residency programs.

Design: A 20-item questionnaire was distributed to all fourth-year medical students at the University of Kansas School of Medicine.