Why I Chose Breast Oncology

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Carla Fisher, MD

Carla Fisher, MD

Like many others, my path into the field of oncology was not a direct one. After making the decision to enter medical school, I chose to pursue a career in surgery followed by a specialization in breast oncology. As I look back, each choice was made for different reasons at different times and ultimately I am so happy with the career that I now enjoy.

I am a breast surgeon. I see patients in the office with breast cancer, abnormal mammograms, breast masses, breast pain, etc. Essentially, I see women with multiple breast complaints, but most of my patients have cancer or require surgery to determine if they have cancer.

To get to where I am today, I completed a general surgery residency, which is usually a 5 to 7 year program. Surgery was always something I was interested in as a medical student. I loved the hands-on aspect of what I was doing. I liked that I could really “fix” things with my hands. It was fast paced and exciting and eventually, I could not see myself doing anything else.

As a general surgery resident I was exposed to operations involving the lungs, heart, bowel, liver, gallbladder, every major blood vessel, thyroid, breast, among other organs….and while I initially liked “fixing” problems with surgery I soon realized that not every problem needed to be fixed and some problems weren’t fixed in the operating room. There was a finesse required to be a good surgeon that I slowly learned over many years. The field of Surgical Oncology really challenged this finesse. When I was evaluating patients in clinic with cancer, there were always complex questions around their care. Did we need to look for cancer elsewhere? Was surgery really going to help the patient and if so, when was the best time for surgery? Would I recommend that the patient be given chemotherapy or radiation to help shrink the cancer before surgery? Would the patient’s outcome be improved if I gave them chemotherapy now or after surgery? It was clear that Surgical Oncology combined my interests of working with my hands as well as enjoying the complexities of treating patients outside of the operating room. In addition to this, Surgical Oncology really gave the surgeon an opportunity to develop a relationship with his/her patient and I LOVED this. While I loved operating, I really found purpose in the relationships I developed with the patients before and after surgery.

Towards the end of my surgical residency I rotated on the breast service. While I spent most of my time in the operating room, I also worked with the radiation oncologists, the pathologists, the radiologists and plastic surgeons. The treatment of breast cancer was truly a multi-disciplinary effort and I had found my future career. I completed a one year fellowship in breast surgery and rotated through even more specialties; including medical oncology and genetics.

As a breast surgeon, I am involved in a wide variety of surgeries including large, combined cases with plastic surgeons and many small outpatient cases. My patients do not go to the operating room just to removal a lump or a breast cancer; they go after a careful work up, including physical exam, imaging, sometimes biopsy or consultation with a plastic surgeon, radiation oncologist or medical oncologist. The field of breast oncology is also on the cutting edge of research with new articles being published every week regarding chemotherapy regimens, surgical choices, new radiation techniques, exercise in the post-operative patient, etc. and this requires that I am always reading and always learning.

As a surgeon I have had the opportunity to biopsy cancers in my office, inject vaccines into the breast and place radiation catheters in the operating room. To me, the opportunities as a surgical oncologist are limitless. At the end of the day, however, it is my patients that make this job so rewarding. My patients can be challenging, inquisitive and are always appreciative. They remind me of what an awesome job I have.