Dr. Deanna Attai: Ground-Breaking Breast Surgeon and Educator
Dr. Deanna Attai has had a distinguished career as a breast surgeon. Dr. Attai graduated with honors from Georgetown University School of Medicine in 1990. She then completed residency at Georgetown University Medical Center in 1995, and was certified by the American Board of Surgery in 1997.
Dr. Attai is a past-President of the American Society of Breast Surgeons. As an educator, most recently as an Associate Clinical Professor of Surgery at the David Geffen School of Medicine at UCLA, her research focused on using social media to facilitate patient partnerships and address various aspects of the patient experience.
Perspectives on patient communication
Patient communication is "one of the joys of breast surgery and part of what drew me to the field," Dr. Attai says. She long saw the doctor-patient relationship as a partnership. With a genuine two-way dialogue, both parties gain.
"Cancer can be very isolating," Dr. Attai explains. "Even if you may have friends and family and a good support system, it's nice to be able to talk to someone who's been going through the same thing."
Online support and breast cancer
Just retired from 38 years in medicine, which included multiple practice settings and leadership and research experiences, Dr. Attai, until recently, was co-moderator of Breast Cancer Social Media (#BCSM), the first breast cancer support community established on X (formerly Twitter).1
Dr. Attai co-authored a study aimed to describe the growth and changes in the #BCSM online community and to discuss future directions and lessons that may apply to other online support communities.1
Impacts of breast cancer in men
A great supporter of men dealing with breast cancer diagnosis and treatment, Dr. Attai recently co-authored, "Treatments for breast cancer in men: late effects and impact on quality of life," a study that found that men suffer several late side effects from treatments for breast cancer.2
In conversation with Dr. Attai
Gender equality in the surgery field
Q: An obvious first question is, what was it like as a woman training to be a surgeon back in the day? What progress have you seen in terms of gender equality in your field?
A: There were some "interesting" early experiences, for sure! During my internship year at Georgetown, I was the only female trainee in the department of surgery, and women remained in the minority during my time there. However, I always felt that I was provided with the same opportunities (and was subject to the same criticisms) as my male colleagues.
The field of surgery is much more diverse compared to when I started, but women and minorities continue to face harassment and discrimination and often are not provided with the same opportunities for career advancement. There is much room for improvement.
As a side note, I was the subject of a documentary a few years ago that explored this topic in more detail.
Patient-centered care
Q: What qualities must a surgeon bring to the job in an era when patients want more from their medical providers than just a good job?
A: I think patients have always wanted more than just a technically good surgeon with sound judgement skills, but care that respected patient preferences and values was not always provided.
In all aspects of medicine, all discussions of treatment options should include conversations about patient goals of care and healthcare priorities. It is up to the physician to engage the patient in a shared decision-making conversation and encourage them to express any concerns regarding treatment options. The "best" medical decision may not be the right one for an individual patient.
Challenges in practice
Q: What were some of the biggest challenges you faced during your 30 years in practice, and how did you overcome them?
A: Regarding patient care, it took some time to find the right balance between having a compassionate and empathetic relationship with my patients and not internalizing their entire situation (such as the impact of a breast cancer diagnosis on the individual and their family, etc.). Personal boundaries were necessary, but that took some time.
Regarding my overall practice, the most challenging times were my 13 years in solo private practice. I was the surgeon, office manager, HR director, and more. However, those were some of the most rewarding years of my career. I think I overcame the challenges by relying on the advice and support of private practice colleagues and mentors (that I found through the American Society of Breast Surgeons) and my own stubbornness and persistence.
Dealing with stress
Q: How did you manage the stress and emotional challenges of being a surgeon?
A: Not always very well! Early on, my pattern would be to just "hunker down" when working through a stressful period. Later in my career, after my autoimmune diagnosis, I started gardening, which proved to be an incredible outlet for stress and emotional challenges.
Advancements over time
Q: What advancements in surgical techniques or technology have had the most significant impact on patient care?
A: In breast surgery, I feel so fortunate to have practiced during a time when we recognized that more is not better. I lived through the shift from mastectomy to breast conservation, axillary node dissection for everyone (including clinically node-negative) to sentinel node biopsy or even omission of axillary sampling, and selective use of ablative therapy such as cryoablation.
De-escalation of care is a buzzword in breast oncology, and I think it's a welcome change when we can dial back some of our treatments (and the associated toxicities or complications) and not negatively impact outcomes.
Retirement plans
Dr. Attai has retired from her professional duties. As she has said, "My plans in retirement are to try to reverse some of the damage a long career in surgery has caused, so that means lots of rest and the restorative powers of the garden." She wishes younger colleagues "good health and the hope that you finish your careers with as full a heart as I have right now."
Join the conversation