Brigid Killelea, MD, MPH, chief of breast surgery for Yale Medicine, performs lumpectomies, mastectomies and other surgeries to treat breast cancer. She has a special interest in oncoplastic breast surgery, also known as partial mastectomy—essentially a lumpectomy followed by a simple, yet effective reconstructive surgery that minimizes cosmetic defects and scar tissue.
Before she decided to become a breast surgeon, Dr. Killelea spent two years as a Peace Corps volunteer, and lived in a small community in Paraguay without electricity or running water. That experience inspired her to pursue a master’s in public health, and then she decided to go for a medical degree. “The way I think about it now is that this specialty picked me,” she says. “It's a combination of so many things I feel passionate about—even in the Peace Corps, I was interested in women’s health. And when you work in breast surgery, the patients are inspiring on a daily basis, so my interest and my love for the field just continues to grow.”
While each case is different, Dr. Killelea says survival rates for breast cancer are constantly improving. She gives credit to mammography screening in the U.S., which allows doctors to detect cancer in its earliest stages, when it can often be treated with fewer surgeries. Dr. Killelea says new patients who start out wanting double mastectomies often choose a less invasive procedure once she provides them with options and data on outcomes.
“There is always a lot of anxiety, fear and emotion that runs through a woman's head when she's coming to talk to me for the first time,” Dr. Killelea says. Sometimes the worst part is waiting for information, which can be another appointment away. “I understand that it just feels like an eternity.” Most breast patients will see some combination of three specialists: a breast surgeon, an oncologist and a therapeutic radiologist. The Breast Center at Smilow Cancer Hospital makes sure all three types of specialists are available to consult with each other and often see the patient during the initial visit. “It helps just knowing that there is a plan, knowing what's going to happen next and knowing that they're going to be well taken care of,” she says.
An associate professor of surgery (oncology) at Yale School of Medicine, Dr. Killelea has a special interest in disparities in breast cancer care among different populations. A particular concern is aggressive “triple negative” breast cancer, which affects African-American women more than it does Caucasian women, and doesn’t respond to common treatments that are effective for other types of breast cancer. “I've become very interested in trying to figure out why that is true,” she says.
The more women doctors and patients know about breast cancer, the more choices and better outcomes everyone will have, she says. “Patients come back years later, and so much of that fear is gone, and they tell me about their kids and their families and life events that they're so happy to be a part of. It really makes it worth it,” Dr. Killelea says.