Week 1 in the books

Before this clinical immersion experience, I hadn’t witnessed areas of doctors' offices and hospitals beyond what a typical patient experiences. For my research in Ithaca, I am working on a medical device related to breast cancer. Most of us have heard the statistic that 1 in 8 women will be diagnosed with breast cancer at some point in their lives. So as you can imagine, most women and some men will rely on diagnostic imaging. I have watched videos of procedures, read literature, and even dabbled in the personal blogs of those affected by breast cancer, but this week I witnessed the actions involved and the gravity that they carry. 

My clinical mentor, who is Jennifer Marti, was out of the office this week so I rotated with several clinicians and shadowed the following:

-I began with a fellow, Jay, who was actually on the last day of his fellowship. He was in the diagnostic imaging room and he walked me through some screening and diagnostic mammograms. He explained the logistics of the images, what we were looking for, and how to grade the possible disease.

-Next, I worked with Dr. Dodelzon and watched her perform one stereotactic biopsy and two ultrasound biopsies of breast lesions. The stereotactic biopsy uses mammography from two different angles to pinpoint an XYZ coordinate of where the biopsy should be taken, the needle (which is big, about 9 gauge) is programmed to be inserted to the correct depth. The needle uses suction and chopping to removed the sample which is then x-rayed to make sure the desired area was captured. The ultrasound biopsy is less invasive and uses a smaller gauge flexible needle to capture samples.

-Next, I worked with Dr. Mema and we looked over MRI images. MRI uses a contrast agent to distinguish suspicious tissue from normal tissue or else the breasts light up on MRI (great sensitivity but low specificity). 

-Next, I worked with Dr. Destefano and watched two radioactive seed implantations. These seeds are placed before surgical lump removals in the breasts. The radioactivity of the seeds is extremely minimal; they are inserted as a guide to the surgeon who will perform the surgery the following day. The surgeon uses a device to look for the seed, resecting the lesion until the seed is removed. This procedure was fairly simple as it did not cause the patient much discomfort and was over fairly quickly. We talked about the many options between seeds and clips that are placed in the breast (such as RF clips). 

Overall, I learned and experienced many things. NYC has also been treating me nicely.