Massachusetts General Hospital Cancer Center, Boston, Massachusetts

I'm Dr. Barbara Smith and I'm head of the breast surgery group at the Massachusetts General Hospital. Our research program has focused on ways to reduce the extent of surgery and radiation required for women with breast cancer.

We've been active in the sentinel node biopsy studies, which remove only one or two nodes instead of the traditional 10-15 nodes and this smaller surgery dramatically reduces the risk of complications.

Our particular interest has been looking at women who have tumor in their sentinel nodes and trying to avoid the full axillary dissection that has been standard. We've run a large study that looks at using radiation instead of axillary dissection and have found very low rates of recurrence with this approach and many fewer complications than with axillary dissection.


We're continuing to use this approach in other studies. We're also trying to reduce the length of radiation that's required after lumpectomy and have been running trials that use only five days of radiation instead of the traditional six-and-a-half weeks.

We've also been looking at ways to preserve the nipple for women who are requiring mastectomy and have done some detailed anatomic studies and physiological studies to show safe ways to leave the nipple for women undergoing mastectomy.

We're also very actively participating in studies that prevent breast cancer through the use of medications such as aromatase inhibitors.

We've taken advantage of the hormonal expertise in our group to look at studies of how long hormonal therapy needs to be given after breast cancer to see where ten years is enough or whether fifteen years is better. And we're also looking at ways to let women who've been treated in the past for HER2-positive breast cancer and did not have the opportunity to receive Herceptin to come back at a later time to receive Herceptin or one of the newer drugs Lapatinib as a way to help prevent recurrences.

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