Spotlight on Dr. Katharine Armstrong

St. Joseph’s/Candler Breast Surgeon Dr. Katharine Armstrong offers oncoplastic technique for the best possible outcome for breast cancer patients

SJ/C: What made you decide to become a doctor?

It was not something I wanted to do when I was a kid. Most of my family members were teachers, and I thought I’d be a Spanish teacher for a long time. When I was a junior in high school, I took AP biology, which I only took because my brother took it, and I wanted to do everything he did. I fell in love with it. I couldn’t stop telling my mom everything I was learning at school. I got really interested in anatomy and the human body. At the same time, I had some family members that were going through different medical problems and that was the first time I’d really been exposed to the medical system and doctors. I had this thought that it would be something I would enjoy and never really looked back from there.

SJ/C: Why did you decide to become a breast surgeon?

I didn’t go into medical school thinking that I wanted to do surgery. I initially wanted to do pediatrics or pediatric oncology. I was always interested in cancer. I fell in love with surgery as a third-year medical student and shifted gears. I felt like I wanted to do something oncology-related, and when I did my breast surgery rotation as a second-year resident, everything kind of clicked. It was the first time since I started residency where I saw somebody – my eventual mentor, Dr. Maxwell – and thought, ‘I really think I can do that. I really could see myself doing that long term.’

It was the right combination of things. I was always interested in tumor biology. I liked the idea of working with a multi-disciplinary team of different cancer experts. With all the different advancements and options we have these days, there’s a lot of hope in breast cancer. We treat people with the expectation now that they are going to live many, many years to come. I think that appealed to me because we were thinking more about somebody’s quality of life in the decisions we were making, even as it came to surgical decisions. Is there some sort of oncoplastic technique we can use that will leave somebody so that they are not deformed, but have a really nice aesthetic outcome in addition to their excellent oncologic outcome? I really liked the fact the patient and their life going forward were part of the conversation.

SJ/C: Do you only treat breast cancers or are their other conditions you treat?

I treat mostly breast cancer, but I also treat benign conditions of the breast. I treat women who are at high risk of breast cancer, whether that’s due to family history or genetic mutations or high-risk lesions found on biopsies.

SJ/C: How do you use technology when it comes to breast surgery?

I think the biggest thing that I do, something that has been imparted in my training since I was in residency, is that I really love oncoplastic breast surgery. When I was a medical student, the only breast surgery I knew was a flat closure mastectomy. That was the only thing I had been exposed to. When I was a resident, I saw people having lumpectomies at the same time as they were undergoing a reduction or lift. I was introduced to a doctor named Mel Silverstein, who’s like the American godfather of oncoplastics. He really changed the way many of us, myself included, think about breast cancer from a surgical standpoint. It’s not exactly new but it’s a lot more popular these days than it was 20 years ago. It’s something that’s definitely more emphasized in training programs now than it has been in the past.

I was very fortunate, even in my infancy as a breast surgeon, that the people who were training me and pushing me toward breast surgery as a career, always employed that oncoplastic mindset. ‘How could we approach this patient in such a way that we minimize their scarring or minimize cosmetic deformity that can happen as a result of breast surgery?’ ‘How do we optimize their oncologic and aesthetic outcome all at the same time?’

SJ/C: What do you see in the future for treating breast cancer?

I think we will continue to try to maximize someone’s oncologic outcome while also minimize the toxicity of all the things we are doing to them while really trying to tailor our treatment to the specific patient and the specific tumor. A lot of the things we are doing across the board whether it’s surgery or with medical oncology or radiation, we really do try to tailor things to the patient. I think that’s going to continue to be the trend going forward.

Dr. Silverstein, who like I said had a massive impact on my wanting to become a breast surgeon, wrote a paper called “From Radical Mastectomy to Radical Conservation: Extreme Oncoplasty.” It talked about his career when he started in the 1960s where everyone got one treatment for breast cancer, which was a radical mastectomy where they took the breast, the muscle and all the lymph nodes. Now, there are many different things we can do based on you, your individual tumor size, your bio makers, the biology of the tumor, all sorts of different things. Even if somebody has more advanced disease, there are still ways to treat it. I think it’s a really exciting time to be a breast cancer specialist.

SJ/C: What is some common advice you’d share with women for their overall health?

Get your mammograms, yearly. Early detection does save lives, and it changes what we can offer somebody. Even to this day, with all the advancements in treatment, it’s still better to be caught early. And, do your self-breast exams. Finding it early makes a huge difference because it really opens up doors to what we can do and what we can offer. If you have a very small, early-stage cancer, the options that I have surgically are increased. Same thing with medical oncology and radiation oncology and the treatments they can offer. Also, know your family history.

Family: I have an older brother, sister-in-law and three little nephews, and my parents – they are all in Atlanta. I also have a dog named Travis, a lab mix.
Hobbies: I love music – going to concerts, singing and live music