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Kathie-AnnJosephMDMPH
(Physician
- Surgery - Breast
(Verified)
)
| Communities: Breast Cancer | Thank You's: 1 |
| Member Since: Sep. 2011 | Questions: 0 |
| Answers: 8 |
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Professional Info
Credential:
MD
Primary specialty:
Surgery - Breast
State Licenses:
NY
Languages:
English,Spanish,Mandarin
Gender: Female
Medical school:
Columbia College of Physicians and Surgeons
Residency:
NYU Medical Center
Internship:
NYU Medical Center
Board certifications:
American Board of Surgery
Professional memberships:
American College of Surgeons, American Society of Breast Surgeons, American Society of Clinical Oncology, Society of Surgical Oncology, NSABP, ECOG, New York Metropolitan Breast Group, New York Surgical Society
Areas of expertise:
Breast Cancer, High Risk Surveillance, Oncoplastic Surgery including Nipple and Areola Sparing Mastectomy, Sentinel Lymph Node Biopsy
Research interests:
Health Disparities of Breast Cancer, High Risk, Quality of Care
Awards and publications:
Gay Clark Stoddard Memorial Award for Compassionate Care from Susan G. Komen Greater NYC, 2009
Southwest Oncology Group Hope Foundation/Ortho Biotech Young Investigator, 2004.
American Association for Cancer Research Minority Scholar Award in Cancer Research, 2004
American Association for Cancer Research Minority Scholar Award in Cancer Research, 2006
NSABP Minority Travel Award, 2007
Publications: http://www.med.nyu.edu/biosketch/josepk01#
Southwest Oncology Group Hope Foundation/Ortho Biotech Young Investigator, 2004.
American Association for Cancer Research Minority Scholar Award in Cancer Research, 2004
American Association for Cancer Research Minority Scholar Award in Cancer Research, 2006
NSABP Minority Travel Award, 2007
Publications: http://www.med.nyu.edu/biosketch/josepk01#
Hospital affiliation:
NYU Langone Medical Center
Practice name:
NYU Breast Surgery Associates
Practice address:
160 East 34th Street
New York, New York
10016
Practice phone number:
212-731-5858
Personal Bio (My story)
Dr. Kathie-Ann Joseph is Assistant Professor of Surgery at NYU Medical Center and Director of Breast Services for the South Manhattan Network, Health and Hospitals Corporations.
A graduate of Harvard College and Columbia College of Physicians and Surgeons, Dr. Joseph completed her general surgery residency at NYU Medical Center and her breast surgery fellowship at Columbia. Dr. Joseph has a keen research interest in health disparities and has been recognized for her compassion and dedication to her patients when she was awarded the Gay Clark Stoddard award by the Susan G. Komen Greater NYC in 2009.
Dr. Joseph lectures widely, has numerous peer reviewed publications, serves on several national committees and recently joined the medical advisory board of Susan G. Komen Greater NYC.
A graduate of Harvard College and Columbia College of Physicians and Surgeons, Dr. Joseph completed her general surgery residency at NYU Medical Center and her breast surgery fellowship at Columbia. Dr. Joseph has a keen research interest in health disparities and has been recognized for her compassion and dedication to her patients when she was awarded the Gay Clark Stoddard award by the Susan G. Komen Greater NYC in 2009.
Dr. Joseph lectures widely, has numerous peer reviewed publications, serves on several national committees and recently joined the medical advisory board of Susan G. Komen Greater NYC.
Kathie-AnnJosephMDMPH Activities
If you have inflammatory breast cancer by definition it involves the skin. When I have patients with IBC who has completed treatment, I evaluate them clinically and I also take punch (skin) biopsies to make sure there is no further involvement of cancer in the dermis of the skin before I perform a mastectomy. I would generally take an ellipse of skin around the nipple areola complex including any areas that may have been involved by cancer that to reduce the risk of local recurrence. Hope this helps and good luck.
If you have inflammatory breast cancer by definition it involves the skin. When I have patients with IBC who has completed treatment, I evaluate them clinically and I also take punch (skin) biopsies to make sure there is no further involvement of cancer in the dermis of the skin before I perform a mastectomy. I would generally take an ellipse of skin around the nipple areola complex including any areas that may have been involved by cancer that to reduce the risk of local recurrence. Hope this helps and good luck.
New answer by Kathie-AnnJosephMDMPH (Physician - Surgery - Breast (Verified)) in topic(s) Inflammatory Breast Cancer, Breast Surgery
3
Answers |
5 months ago
Yes, as you mentioned Dr. Paul Goss presented the findings on exemestane for breast cancer prevention at ASCO and his group published their findings in the New England of Medicine in June 2011. Like many new findings it may take a while to catch on especially for chemoprevention, as the other options (tamoxifen, raloxifene) have not been popular with either the breast specialists or the patients due to the side effects (menopausal symptoms, blood clots, uterine bleeding, endometrial cancer, cataracts, etc). Asking healthy patients to take medications with minimal or serious side effects can be a hard sell.
Yes, as you mentioned Dr. Paul Goss presented the findings on exemestane for breast cancer prevention at ASCO and his group published their findings in the New England of Medicine in June 2011. Like many new findings it may take a while to catch on especially for chemoprevention, as the other options (tamoxifen, raloxifene) have not been popular with either the breast specialists or the patients due to the side effects (menopausal symptoms, blood clots, uterine bleeding, endometrial cancer, cataracts, etc). Asking healthy patients to take medications with minimal or serious side effects can be a hard sell.
New answer by Kathie-AnnJosephMDMPH (Physician - Surgery - Breast (Verified)) in topic(s) Cancer Prevention, Breast Cancer Prevention, Breast Cancer, Exemestane (Aromasin), Post-menopausal
1
Answer |
5 months ago
Dear Mary, the decision you made was a very personal decision. There is no right or wrong in a situation like this. Many women are choosing bilateral mastectomies for reasons very similar to the reasons you described: peace of mind. I have many women in my practice who make similar decisions in similar situations and don't look back. I hope you are doing well and wish you all the best.
My choice was solely based on peace of mind,although my right breast was never infected. I had four tumors and lymph node infected on the left side. For me, it made more sense to reduce the amount of breast tissu available to make sure I had less chances of recurrence. Was I right? I hope so. Anyway, I don't stay up at night wondering if I should have. That way, I feel like I have done everything in my power to make sure it wouldn't come back. Being only 34 at the time of the diagnostic and with two toddlers, it was the only choice that made sense. I choose the live and not having to go through this again. Besides, doing it both sides helped to facilitate reconstruction, which was not a small benefit! :)
Mary
Mary
New answer by Kathie-AnnJosephMDMPH (Physician - Surgery - Breast (Verified)) in topic(s) Patient Decisions, Breast Cancer, Breast Surgery, Lumpectomy, Mastectomy
4
Answers |
5 months ago
Most women choose close surveillance, seeing their breast specialist twice a year for breast examinations along with screening. In addition to that, you may be referred for chemoprevention or hormonal treatment such as tamoxifen or if post-menopausal (raloxifene, exemestane).
It is not necessary to have a mastectomy for ADH alone. Most women choose close surveillance, seeing their breast specialist twice a year for breast examinations along with screening. In addition to that, you may be referred for chemoprevention or hormonal treatment such as tamoxifen or if post-menopausal (raloxifene, exemestane).
It is not necessary to have a mastectomy for ADH alone.
It is not necessary to have a mastectomy for ADH alone. Most women choose close surveillance, seeing their breast specialist twice a year for breast examinations along with screening. In addition to that, you may be referred for chemoprevention or hormonal treatment such as tamoxifen or if post-menopausal (raloxifene, exemestane).
It is not necessary to have a mastectomy for ADH alone.
New answer by Kathie-AnnJosephMDMPH (Physician - Surgery - Breast (Verified)) in topic(s) Reduce Breast Cancer Risk, Cancer Risk, Breast Cancer, Atypical Ductal Hyperplasia, Breast Cancer Risk, Reduce Cancer Risk, Cancer
1
Answer |
5 months ago
LCIS, or lobular carcinoma in situ, is a misnomer as it's not a cancer but rather a benign high risk lesion for cancer. It's asymptomatic, generally not seen on mammography; it's an incidental finding on biopsy for another reason. Keep in mind that the increased risk in not only for the breast that the LCIS was found in but for both breasts.
LCIS, or lobular carcinoma in situ, is a misnomer as it's not a cancer but rather a benign high risk lesion for cancer. It's asymptomatic, generally not seen on mammography; it's an incidental finding on biopsy for another reason. Keep in mind that the increased risk in not only for the breast that the LCIS was found in but for both breasts.
New answer by Kathie-AnnJosephMDMPH (Physician - Surgery - Breast (Verified)) in topic(s) Breast Cancer, Stage 0 (LCIS) Breast Cancer, Cancer
1
Answer |
5 months ago
For all the great progress made in breast cancer treatment, disparities do persist. The incidence of breast cancer is 17% lower in African-American women than in white women but the mortality rates are 41% higher in African-American women than in white women. African-American women are more likely to delay getting a biopsy and five times more likely to delay getting treatment once diagnosed.
While Hispanic/Latina women have a lower incidence of breast cancer, they are more likely to be diagnosed with larger tumors and at advanced stage.
When Asian women migrate to the US, their risk of developing breast cancer increases up to six-fold.
We also know that women who lack health insurance and have less than a high school education are less likely to obtain mammograms.
Hope this is helpful, there is so much more but I could give a talk about this! For all the great progress made in breast cancer treatment, disparities do persist. The incidence of breast cancer is 17% lower in African-American women than in white women but the mortality rates are 41% higher in African-American women than in white women. African-American women are more likely to delay getting a biopsy and five times more likely to delay getting treatment once diagnosed.
While Hispanic/Latina women have a lower incidence of breast cancer, they are more likely to be diagnosed with larger tumors and at advanced stage.
When Asian women migrate to the US, their risk of developing breast cancer increases up to six-fold.
We also know that women who lack health insurance and have less than a high school education are less likely to obtain mammograms.
Hope this is helpful, there is so much more but I could give a talk about this!
While Hispanic/Latina women have a lower incidence of breast cancer, they are more likely to be diagnosed with larger tumors and at advanced stage.
When Asian women migrate to the US, their risk of developing breast cancer increases up to six-fold.
We also know that women who lack health insurance and have less than a high school education are less likely to obtain mammograms.
Hope this is helpful, there is so much more but I could give a talk about this! For all the great progress made in breast cancer treatment, disparities do persist. The incidence of breast cancer is 17% lower in African-American women than in white women but the mortality rates are 41% higher in African-American women than in white women. African-American women are more likely to delay getting a biopsy and five times more likely to delay getting treatment once diagnosed.
While Hispanic/Latina women have a lower incidence of breast cancer, they are more likely to be diagnosed with larger tumors and at advanced stage.
When Asian women migrate to the US, their risk of developing breast cancer increases up to six-fold.
We also know that women who lack health insurance and have less than a high school education are less likely to obtain mammograms.
Hope this is helpful, there is so much more but I could give a talk about this!
New answer by Kathie-AnnJosephMDMPH (Physician - Surgery - Breast (Verified)) in topic(s) Breast Cancer, Health Disparities, Cancer
2
Answers |
5 months ago
High risk lesions such as atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH) and LCIS (lobular carcinoma in situ) or lobular neoplasia when identified on a needle biopsy are often followed by an open excisional biopsy as there is a 10-20% incidence of an associated cancer.
Patients can be offered chemopreventive agents such as tamoxifen or raloxifene. However, most women are generally followed twice a year with physical examinations and annual mammograms. High risk lesions such as atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH) and LCIS (lobular carcinoma in situ) or lobular neoplasia when identified on a needle biopsy are often followed by an open excisional biopsy as there is a 10-20% incidence of an associated cancer.
Patients can be offered chemopreventive agents such as tamoxifen or raloxifene. However, most women are generally followed twice a year with physical examinations and annual mammograms.
Patients can be offered chemopreventive agents such as tamoxifen or raloxifene. However, most women are generally followed twice a year with physical examinations and annual mammograms. High risk lesions such as atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH) and LCIS (lobular carcinoma in situ) or lobular neoplasia when identified on a needle biopsy are often followed by an open excisional biopsy as there is a 10-20% incidence of an associated cancer.
Patients can be offered chemopreventive agents such as tamoxifen or raloxifene. However, most women are generally followed twice a year with physical examinations and annual mammograms.
New answer by Kathie-AnnJosephMDMPH (Physician - Surgery - Breast (Verified)) in topic(s) Reduce Breast Cancer Risk, Cancer Risk, Breast Cancer, Breast Cancer Risk, High Risk Lesions, Reduce Cancer Risk, Cancer
1
Answer |
5 months ago
I'm assuming you mean LCIS (lobular carcinoma in situ or lobular neoplasia) discovered by a core needle biopsy. Yes, it is advisable to the lesion removed as there is a 10-20% incidence of an associated invasive cancer.
I'm assuming you mean LCIS (lobular carcinoma in situ or lobular neoplasia) discovered by a core needle biopsy. Yes, it is advisable to the lesion removed as there is a 10-20% incidence of an associated invasive cancer.
New answer by Kathie-AnnJosephMDMPH (Physician - Surgery - Breast (Verified)) in topic(s) Cancer Risk, Breast Cancer, Stage 0 (LCIS) Breast Cancer, Breast Cancer Risk
1
Answer |
5 months ago
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