University of Southern California (USC)

Keck School of Medicine (Norris Comprehensive Cancer Center, Keck Hospital, and LAC+USC (LA County) Hospital) and Hoag Memorial Hospital

Los Angeles, California
Associate Program Director: Maria E. Nelson, MD

The University of Southern California (USC) Breast Service and Breast Fellowship are unique. Keystones of the program include oncoplastic surgery techniques, multidisciplinary management of locally advanced breast cancers, exposure to clinical trials, long-term studies of ductal carcinoma in situ, and interest in emerging technologies.

Oncoplastic surgery combines the tenets of oncologic surgery with the techniques of plastic surgery to achieve an optimal cosmetic and oncologic result. USC breast fellows learn how to use a range of creative excisions for nipple and skin-sparing mastectomies and for breast-preserving procedures. These include new techniques such as the batwing, hemi-batwing, triangle resection, inframammary approach, donut-hole mastopexy, and a range of incisions for breast reduction. Exposure to reconstructive surgeons and immediate breast reconstruction techniques using tissue expanders, implants, and autologous flaps provides fellows with an in-depth knowledge of how to integrate cancer excision with reconstruction procedures.

New Technologies

In conjunction with our oncoplastic approaches, the USC program provides experience with new technologies, including partial breast irradiation, intraoperative radiation therapy (IORT), in situ ablation, intraoperative ultrasound, clinical trials, breast MRI, sentinel node and targeted axillary dissection, and lymphatic mapping. Fellows are also trained to do core biopsies using vacuum-assisted devices with ultrasound guidance during breast radiology clinics.

Facilities and Faculty

The USC Breast Service and Breast Fellowship Program is based at three hospitals. Hoag Memorial Hospital is a private facility in Newport Beach where specialized care is provided to more than six thousand breast cancer patients each year and where Dr. Mel Silverstein is the Breast Program Director. The Hoag Breast Care Center is staffed by a multidisciplinary team of breast radiologists and surgical oncologists and is specifically designed to meet all the needs of the breast cancer patient. Breast radiology includes five digital mammography units, a tomomammography unit, a dedicated breast MRI, ultrasound units, and stereotactic biopsy services.

Los Angeles County-USC Medical Center (LAC+USC) is a public county institution that serves as a tertiary care facility for the underserved population of Los Angeles. At LAC+USC fellows manage a busy outpatient clinic  and take an active role teaching residents in the USC General Surgery Program  in the operating room and outpatient clinic. The patient population consists in large proportion of those with locally advanced cancers. Therefore, fellows become acquainted with the multidisciplinary approach to these patients. A weekly multidisciplinary conference moderated by the program director allows all services to participate in the learning environment and complex treatment plans. 

USCKeck Medical Center/Kenneth Norris Comprehensive Cancer Center and Norris Cancer Hospital in Los Angeles is a NCI-designated center that is a leader in cancer treatment, research, prevention, and education. At Norris fellows join breast surgeons, plastic surgeons, medical oncologists, radiologists, pathologists, and radiation oncologists in the management of breast cancer patients, fulfilling the SSO's fellowship program requirements for multidisciplinary breast education.

Conferences and Rotations

Fellows participate in weekly multidisciplinary breast conferences and radiology/pathology correlation conferences at Hoag, LAC+USC and Keck/Norris. Breast fellows rotate between the three facilities and have ample exposure to the innovative setting of our multidisciplinary breast program. They will be well trained to design and direct community or academically based breast centers.

The USC/Van Nuys Breast Cancer Database managed by Dr. Silverstein has more than 4,500 patients with long-term follow-up, and it is available for fellows to develop clinical research projects and present data at national meetings.   A longitudinal breast cancer database was started in 2009 at Norris and LAC+USC. Past USC fellows have presented at the San Antonio Breast Cancer Symposium, the American Society of Breast Surgeons, and the Society of Surgical Oncology.

Eligibility

Applicants must have completed residency training in general surgery and be eligible  for the qualifying (written) examination of the American Board of Surgery. Exceptions should be discussed on a case-by-case basis with the program director. Once accepted, fellows must obtain a California Medical License prior to beginning clinical rotations.

Breast Surgical Oncology Faculty

  • Stephen F. Sener, MD
  • Melvin J. Silverstein, MD
  • Julie Lang, MD
  • Howard Silberman, MD
  • Heather Macdonald, MD
  • Maria E. Nelson, MD
  • Sadia Khan, MD

CONTACT AND ADDRESS:

Training Program Director: Stephen F. Sener, MD

Professor of Clinical Surgery
Chief, Breast and Soft Tissue Surgery
Address: HCC-2
1520 San Pablo St, Suite 4300
Los Angeles, CA 90033
Phone: 323-442-5876
Fax: 323-442-6887
Email: Stephen.Sener@med.usc.edu
Training Program Associate Director:
 Maria E. Nelson, MD
Assistant Professor of Clinical Surgery
 Email: Maria.nelson@med.usc.edu
Coordinator: Ms. Zoe Bowens
1520 San Pablo Street, Suite 4300 
Los Angeles, CA 90033
Phone: 323-442-5876
Fax: 323-442-6887
Email: Zoe.Bowens@med.usc.edu