New York Health breast surgeon talks the most challenging—and rewarding—parts of the job

Occasionally, we schedule our rounds with Healthcare Brew readers. Want to be featured in an upcoming edition? Click here to introduce yourself.

We’re revamping our Making Rounds column, where we feature experts in the healthcare industry and highlight what they do, the challenges and misconceptions they face, and the parts of their jobs that bring them the most joy.

This edition, we’re featuring Craig Larsen, a breast surgeon with New York Health who works specifically with breast cancer patients.

He spoke with Healthcare Brew about some things people might not realize breast surgeons do—as well as what he finds most gratifying about his work.

“There’s nothing more rewarding than guiding patients through their breast cancer journey,” he said.

This interview has been lightly edited for length and clarity.

How would you describe your specific job to someone who doesn’t work in healthcare?

I’m a breast surgeon and I specialize in treating patients with breast cancer and benign breast diseases. My job involves performing surgeries to remove cancerous or noncancerous breast tissue such as lumpectomies (removing a portion of the breast to treat the cancer) and mastectomies (removing the entire breast). I work with a team of doctors to provide comprehensive care for patients, including plastic surgeons, medical oncologists, radiation oncologists, and palliative care physicians.

What’s the biggest misconception people might have about your job?

While many people are aware of breast cancer surgeries, there are still several misconceptions about the role of breast surgeons. One of the most common misconceptions is that breast surgeons perform cosmetic procedures like breast augmentations or reductions. In reality, these procedures are typically performed by plastic surgeons.

With breast cancer, there are often two types of surgeons involved, and both are present at the time of surgery. A general surgeon with specialized training in breast cancer (like me) performs the surgical removal of the breast tissue or the entire breast. Then a plastic surgeon will perform the breast reconstruction surgery.

Another misconception is that breast surgeons are solely involved in the surgical removal of breast tissue before passing the patient on to another specialty for follow-up. While surgery is a significant part of the treatment, breast surgeons play a crucial role in the overall care of patients. They work closely with medical oncologists to provide comprehensive care, from initial diagnosis to long-term follow-up.

Finally, there are still many who believe that breast cancer is incurable. While there are advanced cases, most breast cancers can be treated successfully. Breast cancer surgeons and medical oncologists work together to develop personalized treatment plans that aim to eradicate the cancer and improve patient outcomes.

What’s the most fulfilling aspect of your job?

There’s nothing more rewarding than guiding patients through their breast cancer journey. From explaining their diagnosis to supporting them through treatment and follow-up, it’s incredibly fulfilling to build lasting relationships with patients and their families.

What healthcare trend are you most optimistic about, and why?

I’m most optimistic about the trend toward prevention and de-escalation of treatment in healthcare, particularly in breast surgery. A good physician strives to prevent disease, rather than just treat it. Over the years, there have been significant advancements in breast cancer treatment, moving from aggressive, sometimes brutal surgeries to less invasive options and highly targeted therapies that are tailored to individual patients and their specific diagnosis. I hope that future treatments become so personalized and effective that we’ll look back on the more invasive approaches of the past as outdated.

Tell us about any medical advantage that’s made your life easier.

One of the most challenging aspects of breast surgery is the patient’s disappointment regarding the loss of sensation that often occurs. Because of the nature of the surgery and the way that sensory nerves traverse the breast tissue, there is usually some level of numbness after mastectomy. However, the collaborative relationships between breast and plastic surgeons, combined with advancements in nerve identification, preservation, and surgical nerve reconstruction have significantly improved our ability to maintain or restore some sensation in patients after mastectomy. This has made a positive impact on the quality of life for many patients.