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Hoag Physicians Selected to Teach Unique Breast Conserving Operative Technique at National Meeting for The American Society of Breast Surgeons

Categories: Press Room

NEWPORT BEACH, Calif., April 27, 2017 --- Melvin J. Silverstein, M.D., Hoag Breast Center Medical Director and the Gross Family Foundation Endowed Chair in Oncoplastic Breast Surgery and Nirav Savalia, M.D., Director of Oncoplastic and Aesthetic Breast Surgery at Hoag, were among the faculty selected by the American Society of Breast Surgeons to teach the Annual Oncoplastic Breast Surgery Course at the national meeting held this year in Las Vegas on April 26-30, 2017.

This prestigious opportunity allowed Drs. Silverstein and Savalia to discuss and teach the Split Reduction, an operative technique developed and perfected at Hoag, for surgeons across the nation. Combining the principles of oncologic surgery with the techniques of plastic surgery, this technique alters the incision site on a patient’s breast to accommodate tumors that other oncologists said could not be removed without a mastectomy.

“Hoag is the most advanced place in the world for saving breasts for patients who are told they need a mastectomy,” Dr. Silverstein said.

“Women have so many treatment options, including lumpectomies and oncoplastic surgery to remove cancerous tumors while achieving optimal cosmetic and oncologic results. It is surprising that mastectomy is still the default surgical option for breast cancer treatment,” Dr. Savalia added.

In addition, five research poster presentations were presented at the national meeting by Hoag faculty and USC/Hoag Breast Fellows on the following topics:

  • A Comparison of Margin Width in DCIS Patients Treated with Breast Conserving Surgery Plus Whole Breast Radiation Therapy. Data supported the Consensus Guideline: 2 mm is an appropriate minimal margin width for patients with DCIS patients treated with breast conserving therapy plus whole breast radiation therapy. Analysis of our data found a higher local recurrence rate with narrow surgical margins (< 2mm margins) at 31% compared with the adequately excised group (≥ 2mm margins) at 11%.
    • Authors: Sadia Khan, DO, Program Advisor Hoag Breast Center, Melvin J. Silverstein, MD, Hoag Breast Center Medical Director and the Gross Family Foundation Endowed Chair in Oncoplastic Breast Surgery, et al
  • Excision alone for low risk Ductal Carcinoma In-Situ (DCIS) using University of Southern California/Van Nuys Prognostic Index (USC/VNPI). Findings confirm reports that whole breast radiation therapy (WBRT) may be safely omitted in patients with low-risk DCIS. Established the UCS/VNPI algorithm that quantifies five measurable prognostic factors (tumor size, margin width, nuclear grade, age and comedonecrosis) and aids in predicting local recurrence in conservatively treated patients.
    • Authors: Nicole Zaremba, MD (2017 Muzzy Family Endowed Fellowship in Oncoplastic Breast Surgery at Hoag), et al
  • Outcome After Local Invasive Recurrence: The Impact of Original Diagnosis of DCIS Versus Invasive Cancer. Found that patients with an original diagnosis of invasive breast cancer have higher probability of developing an invasive local recurrence when compared to patients with an original diagnosis of DCIS (42% versus 12%).
    • Authors: Julie Wecsler, MD (USC/Hoag Breast Fellow), et al
  • Four-Year Results of a Single Site X-Ray IORT Trial for Early Breast Cancer. Studied intraoperative radiotherapy (IORT) as a safe alternative to whole breast radiation (WBRT) for low-risk breast cancer patients. Found the rate of local ipsilateral breast tumor events is somewhat higher than those reported in WBRT patients but lower than those described in patients treated with excision alone.
    • Authors: Melinda Epstein, Ph.D., et al
  • Intraductal Papillomas: To Excise or Not Excise
    • Authors: Sayee Kiran, MD (USC/Hoag Breast Fellow), et al

This research was presented at the 18th Annual Meeting of the American Society of Breast Surgeons. Joining the Hoag Breast team at the national meeting was the winner of the 2017 International Scholarship in Breast Surgery Juan Cossa, M.D., Associate Professor of Surgery, Clinics Hospital of Montevideo, Uruguay. Dr. Cossa was selected by the American College of Surgeons (ACS) and the American Society of Breast Surgeons (ASBS) and chose to visit Hoag when given the opportunity to study at any cancer hospital in the United States.

“It was an honor to have Dr. Cossa join our team and have the opportunity to teach him about oncoplastic surgery,” said Dr. Silverstein. “Hoag continues to pioneer innovative medical and surgical advancements and it’s a privilege to be able to share that knowledge with surgeons around the world.”


Hoag is an approximately $1 billion nonprofit, regional health care delivery network in Orange County, California, that treats more than 29,000 inpatients and 305,000 outpatients annually. Hoag consists of two acute-care hospitals – Hoag Hospital Newport Beach, which opened in 1952, and Hoag Hospital Irvine, which opened in 2010 – in addition to seven health centers and ten urgent care centers. Hoag is a designated Magnet® hospital by the American Nurses Credentialing Center (ANCC). Hoag offers a comprehensive blend of health care services that includes five institutes providing specialized services in the following areas: cancer, heart and vascular, neurosciences, women’s health, and orthopedics through Hoag’s affiliate, Hoag Orthopedic Institute, which consists of an orthopedic hospital and two ambulatory surgical centers. In 2013, Hoag entered into an alliance with St. Joseph Health to further expand health care services in the Orange County community, known as St. Joseph Hoag Health. Hoag has been named one of the Best Regional Hospitals in the 2016 - 2017 U.S. News & World Report, andBecker’s Hospital Review named Hoag as one of the 2016 “100 Great Hospitals in America” – a designation Hoag has received four times. National Research Corporation has endorsed Hoag as Orange County’s most preferred hospital for the past 20 consecutive years and, for an unprecedented 21 years, residents of Orange County have chosen Hoag as one of the county’s best hospitals in a local newspaper survey. Visit www.hoag.org for more information.


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