American Society of Breast Surgeons Presidential Address: Treatment by Chance

In a prior Presidential Address I talked of how important it was to have an attitude of gratitude. I still maintain this and am grateful for all the opportunity that life and the American Society of Breast Surgeons have afforded me. Mentors. Mentors come in many forms and sometimes are lifelong and span continents. In terms of my initial surgery and research training, J.J. Marshal, PhD, Edward M. Copeland, MD, Kirby I. Bland, MD, Charles Badgwell, MD, Farhat Moazam, MBBS, Tim Flynn, MD, and Wiley ‘‘Chip’’ Souba, ScD, MD have contributed greatly to my training not only in surgery but in the laboratory in which I spent four of my years. During that training my fellow residents were a constant stimulus to know more, do more, create more, and write more. Beyond those initial years others have afforded more opportunities and advised me on organizational paths to achieving my goals including but not limited to Ted Copeland, MD and Kirby Bland, MD, Charles Balch, MD, Dr. Fabrizio Michelassi, MD, Shirley Graves, PhD, Carlos Pelligrini, MD, David P. Winchester, MD, Jack Hollenbeck, MD, Mel Silverstein, MD, Art Lerner, MD, and Vic Zannis, MD. Legislative. I have had the good fortune to be involved in writing six different laws to upgrade the care of breast patients in Arkansas and am grateful for the legislative savvy and work of Josetta Wilkins, PhD and Cherry Duckett. Surgical Colleagues. I am grateful to all the Surgery Department at University of Arkansas for Medical Sciences and my Division, Kent Westbrook, MD, Ronda HenryTillman, Cristiano Boneti, MD, Daniela Ochoa, MD, Anne Mancino, MD, Maureen McCarthy, RN OCN, and Laura Adkins, MPh, Fellows in Diseases of the Breast, and all the nurses and scrubs in the operating room as well as all the members of our multidisciplinary team. Research Colleagues. Thanks to Soheila Korourian, MD, Issam Makhoul, MD, Larry Suva, PhD, ‘‘Tears for Life,’’ Steve Harms, MD, YiHong Kaufmann, PhD and Valentina Todorova, PhD, Laura Adkins, MS and Maureen McCarthy, RN, OCN, Susan Kadlubar, PhD and ‘‘Spit for the Cure,’’ Sharp Malak, MD, MPH, Fellows including long-time research partner Isabel Rubio, MD, and contributors and partners in the ABLATE multicenter trial and ARM. More importantly thanks to the more than 25,000 pioneers (patients) who gave of themselves for our breast cancer research at the Winthrop P. Rockefeller Institute. Education. My partners in education have been my Breast Cancer Challenge Organizing Committee from Kansas, Oklahoma, Missouri, and Arkansas including our Program Chair this year, Julie Margenthaler, MD, and Committee Chairs and Members who went through a GREAT planning process this year. Thanks to Jane and all her posse for her inordinate leadership as our executive director and workforce. Family. Finally, thanks to my ultimate supporters and facilitators Sam, Spencer, Sade, and to those who have adopted me into their family. There are so many more to thank, so forgive me if I did not include your name but know I appreciate all your efforts on behalf of myself and the mission of the American Society of Breast Surgeons. The title of my address is ‘‘Treatment by Chance.’’ I have taken the title of this talk from an article my former Chair of Surgery at Arkansas Kent Westbrook, MD, who wrote more than 30 years ago about the disparity of care at a time when the debate of the safety of mastectomy versus breast conservation was still raging. In speaking with then President of the American College of Surgeons, Dr. Patti Neumann, she reiterated that what is happening today is no Society of Surgical Oncology 2013