Melissa

Working mom

[Melissa @MMitchellMDPhD]

So fortunate to be able to work with Dr. Kuerer to study de-escalation of radiation in patients who achieve a pathological complete response to neoadjuvant treatment.

[Henry Kuerer @HenryKuerer]

Feasibility of breast conserving surgery alone in HER2-positive invasive breast cancer exceptional responders to neoadjuvant systemic therapy
https://t.co/UO14r0Ucvu

[Melissa @MMitchellMDPhD]

@jryckman3 @ChelainG Agreed, in the B39 trial, DCIS was the one group where there was convincingly no difference in local control between whole breast and APBI. Combined with the fact that there is no known survival advantage for radiation in DCIS, PBI certainly makes sense to minimize toxicity.

[Melissa @MMitchellMDPhD]

@IBCradiation @MDAndersonNews @KHoffmanMD @SFShaitelmanMD @ChelainG Such an honor to work with these wonderful talented and hardworking ladies every day!

[Matthew Ward @MCWardMD]

Earlier this year, we submitted a 900 word letter explaining what we think is a competing risk error in the TARGIT-A pre-pathology update. What we got back was 3,000 words that didn't address the question... (1/13) #radonc #bcsm #iort @SorenBentzen @CShahMD @theRADSofKHAN

[Breast Cancer Action @BCAction]

“Individual value systems can align with approaches and treatments to breast cancer,” - Dr. Van Zee, Memorial Sloan- Kettering Cancer Center + Weill Medical Center of Cornell University in “Molecular Aspects of DCIS Progression.” #SABCS22

[Birgitte Offersen @BOffersen]

The first results from the DBCG PBI trial support standard use of external beam PBI 40Gy/15fr for selected breast cancer pts. Less morbidity and very few cancer events (not related to PBI). PBI has been DBCG standard since 2016 for low risk BC pts.
Graphs & link below 👇

[Peter WT Pisters, MD @ppisters]

Proud for @MDAndersonNews to be ranked as the nation’s leader in cancer care by @USNews. This #1 ranking is a reminder of our responsibilities to those we serve, and it drives our unwavering commitment to our mission to #EndCancer. #BestHospitals

[Melissa @MMitchellMDPhD]

@Rad_Nation @CShahMD @kelseycorrigan @ACurreyMD So nice to hear everyone’s experience. Thank you for the invitation to participate!

[Melissa @MMitchellMDPhD]

@Rad_Nation Some pts are interested in the best local control, others in the best cosmesis, others in convenience or decreased financial toxicity (which can include less time off work or traveling to another city). I tell patients there is no wrong answer, everyone has different priorities.

[Melissa @MMitchellMDPhD]

@Rad_Nation Hard to know if our willingness to rapidly change practice on early evidence will continue w/o the pressures of the COVID pandemic. However, 6 weeks was SOC for decades. Probably less hesitancy to change after experiencing the rapid evolution of breast RT in the last 5-10 yrs.

[Melissa @MMitchellMDPhD]

@Rad_Nation Agree that there is movement towards an approach similar to prostate cancer of active surveillance for low risk early stage breast cancer. Hopefully genomic assays will increasingly determine the true benefit of radiation.

[Melissa @MMitchellMDPhD]

@rlevitinMD @CShahMD @Rad_Nation @Icro_Meattini I emphasize the lack of long term follow up with 5fx and trend of slightly higher long term cosmetic toxicity (though absolute difference 1%). I tend to see 50/50 split. I also have a lot of patients that change their mind 10 times between consult and sim.

[Melissa @MMitchellMDPhD]

@Rad_Nation The covid pandemic, as well as increased comfort with new fractionation schemes likely contributed to faster uptake.

[Melissa @MMitchellMDPhD]

@Rad_Nation There were many naysayers, but after ASTRO guidelines recommended moderate hypofractionation for all breast only patients in 2018, practice dramatically changed. The shift to one week treatment after publication of UKFASTforward happened at a much faster pace.

[Melissa @MMitchellMDPhD]

@Rad_Nation 150 patients on the START trials did receive nodal treatment. Not enough for statistical analysis, but hypothesis generating that moderate hypofractionation may reduce shoulder arthralgias and lymphedema.

[Melissa @MMitchellMDPhD]

Great time today team building with our breast rad onc group at the RAD ONC OLYMPICS!

[Melissa @MMitchellMDPhD]

@JuliaNEM33 I grew up poor with a single mom and my resident salary was much higher than any salary my mom made in her 30 year career. Now I make more in a year than she did in her lifetime and feel guilty, as many family members still make less than a resident salary.

[Melissa @MMitchellMDPhD]

@theRADSofKHAN @Sushilberiwal @CShahMD @ErinGillespieMD @simonpowell213 I do council patients regarding the possible increased risk of pneumonitis, but usually still give concurrent. Since KATHERINE did give concurrent, the recommendation for the current COMPASS RD trial is to give radiation concurrent with adjuvant therapy, which includes T-DM1.