By Lillian Erdahl
I am often asked why I chose to pursue breast surgery out of all the surgical subspecialties. It took me a long time to find this career.
When I was a little girl, I dreamed of growing up to be an actress. In high school, I realized that acting was fun, but my interest in biology and desire to make a difference in the lives of people suffering from disease led me to pursue a career in medicine, and eventually surgery.
As an academic breast surgeon, I still play many roles in my work: technician, counselor, mentor, teacher, learner, researcher, and advocate.. Every day I learn more about the epidemiology and evolving treatment of cancer from working closely with partners in surgery and other disciplines. I continue to learn more about people and how cancer impacts their lives.
In a complex act of bringing together all of these roles, I try to think about identifying the important goals?
My first goal is to treat breast cancer so that the individual affected can live the life that she wants without being stopped by the cancer. My second goal is to limit the negative effects of treatment or to provide the patient with resources and treatments to cope with any side effects that occur. This requires understanding what is important to the woman or man I am treating. Once I know the patient’s goals and the roles that define her, I can combine those with my own goals for her cancer treatment. If she is a farmer, she may rely on her arm strength for her daily work. If she is a mother, she may want to do everything she can to be there for the important milestones in her child’s life. If she is a dancer, she may want her body to look normal in a leotard and have the flexibility to elegantly complete her port de bras.
The algorithm for surgical options has several branch points and these are intimately related with the decisions for systemic and radiation therapy. In addition, family history, personal history, and genetic mutations impact the risk of future cancer and even the potential for different clinical trial enrollment. It makes scripting a treatment plan exciting but also more challenging for me and the patient.
While there are challenges in successfully playing the role of surgeon treating breast cancer, I remember what it must be like to sit on the other side of that conversation. A woman who has recently found out that she has had cancer now has to make a life-altering decision in a one-hour office visit. How can she possibly consider everything she needs to in that brief time period? We must write the script together and it may take consultations with other specialists, return visits, and several revisions before we get it right. When the day of surgery finally arrives, we have rehearsed and revised as a team until we are ready for the performance.
Lillian Erdahl practices breast and general surgery at the University of Iowa. She serves as Associate Program Director in General Surgery as well as the head of the Iowa City VA Medical Center Breast Clinic. Her research interests include breast cancer prevention, faculty development, and simulation in teaching clinical examination.She completed her General Surgery residency at Penn State University including two-year research fellowship in surgical education. After residency, she also completed a one-year fellowship in breast surgical oncology at the Mayo Clinic in Rochester, MN. She is fluent in Spanish and completed a minor in Spanish while pursuing her BS in Biology at Iowa State University.Outside of the hospital, she enjoys yoga, cross-country skiing, cooking, and gardening. Her husband, two children, and cat help her to find joy in each moment of the day.
She microblogs as @lillianerdahl supporting issues and organizations on social media where we all have an opportunity to make an impact. She would like to remind everyone to ask questions about how their donations benefit patients before giving money support breast cancer awareness.
Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author, and are not necessarily the opinion of the Association of Women Surgeons.