Week 2 in the books - Brooke Filanoski

Another week on the upper side east, full of getting lost in the hospital, jumping from one ACed location to another, filling my rings (apple watch), and feeling more like a New Yorker. 


I began the week by attending Dr. Marti’s office hours and shadowing her patient appointments. I sat in on ~ 8 appointments that day. I met women who ranged in age from around 22 to 60. They all had palpable masses. Some were talking to a doctor for the first time about the concern and some had already undergone imaging, biopsy, or even surgery previous to this appointment. Many factors come together to influence the strategy of care. Family history and genetic testing are telling of the patient’s risk. The look of the lump on imaging and the feeling of the lump during an exam are also very telling. Altogether, these factors determine the next steps. Yet, there is room for interpretation and intensity of approach. This varies from surveillance and monitoring to the more extreme approach of a combination of radiation, chemo, and surgery. 


The next day, I sat in on a zoom call tumor board meeting. This board meeting discussed difficult cases where a patient’s treatment plan isn’t obvious. The physicians in the meeting come from different specialties, coming together to discuss their differing opinions. These cases are considered complex and I had a difficult time keeping up with the terminology, but I picked up on the deliberation of the decision-making process as they would come to an agreement before moving onto the next case. 


Additionally, I saw my first surgery - a lumpectomy. Dr. Marti removed a cancerous mass from the breast, along with several axillary lymph nodes. I saw the process start to finish from when the patient entered the OR to when they left. It’s incredible to watch the full OR process, an experience not a lot of people have. The surgical areas had been clipped and seeded. A geiger counter was used to detect radiation in the breast, meaning that once the seed under the tumor had been removed, the breast would no longer give off radiation. The samples of the breast were x-rayed within the OR to make sure that all clips and seeds were removed. I wasn’t sure how I would handle a surgery in person but I did well! Hoping to hop around to other surgeries in the following weeks. 




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