Eun-Sil Hwang

Positions:

Mary and Deryl Hart Distinguished Professor of Surgery, in the School of Medicine

Surgical Oncology
School of Medicine

Professor of Surgery

Surgical Oncology
School of Medicine

Vice Chair of Research in the Department of Surgery

Surgery
School of Medicine

Professor of Radiology

Radiology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1991

University of California - Los Angeles

M.P.H. 2006

University of California - Berkeley

Intern, General Surgery

Kaiser Foundation Hospital

Resident, General Surgery

Cornell University

Fellow, Breast Surgical Oncology

Memorial Sloan-Kettering Cancer Center

Senior Reigstrar, General Surgical Oncology

Singapore General Hospital (Singapore)

Assistant Professor in Residence, Surgery

University of California San Francisco, School of Medicine

Associate Professor in Residence, Surgery

University of California San Francisco, School of Medicine

Chief, Division Of Breast Surgery Oncology

University of California San Francisco, School of Medicine

Professor in Residence, Surgery

University of California San Francisco, School of Medicine

Surgeon-in-Chief, Ucsf Helen Diller Family Cancer Center

University of California San Francisco, School of Medicine

Grants:

Comparing the Effectiveness of Guideline-concordant Care to Active Surveillance for DCIS: an Observational Study

Awarded By
Patient Centered Outcomes Research Institute
Role
Principal Investigator
Start Date
End Date

Breast Pre-Cancer Atlas Center

Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

TBCRC 034: The Incidence of Adjacent Synchronous Ipsilateral Infiltrating Carcinoma and/or DCIS in Patients Diagnosed with Intraductal Papilloma without Atypia or Flat Epithelial Atypia by Core Needle Biopsy

Administered By
Duke Cancer Institute
Awarded By
Johns Hopkins University
Role
Principal Investigator
Start Date
End Date

Tissue tension, RANK and Breast Cancer Risk

Administered By
Surgical Oncology
Awarded By
University of California, San Francisco
Role
Principal Investigator
Start Date
End Date

To estimate the mean change in MRI tumor volume from pretreatment to completion of preoperative endocrine therapy in ER(+) DCIS, as well as to determine whether 3-month change in volume correlates with 6-month change.

Administered By
Surgical Oncology
Awarded By
Alliance for Clinical Trials in Oncology Foundation
Role
Principal Investigator
Start Date
End Date

Publications:

It's not you, It's me: The influence of patient and surgeon gender on patient satisfaction scores.

BACKGROUND: Surgeons face the unique challenge of being responsible for both clinical encounters and surgical outcomes. We aim to explore how patient evaluations of surgeons may be influenced by patient and provider factors. METHODS: Patient responses from the 2016 CGCAHPS survey at a single institution were identified. A Poisson regression model was used to identify patient/provider factors associated with ratings. RESULTS: 11,007 surveys of 134 surgeons were included. After adjustment, higher overall surgeon ratings were associated with older patient age (p < 0.001) and male patient gender (p = 0.001). Lower ratings were associated with higher patient education (p < 0.001) and lower patient self-health ratings (p < 0.001). Although female surgeons tended to have higher communication scores, overall scores did not differ based on any surgeon factors. CONCLUSIONS: Patient satisfaction scores of surgeons are more closely correlated with patient variables than surgeon factors. This may have implications for physician performance evaluation in value-based care models.
Authors
Plichta, JK; Williamson, H; Sergesketter, AR; Grimm, LJ; Thomas, SM; DiLalla, G; Zwischenberger, BA; Hwang, ES; Plichta, RP
MLA Citation
Plichta, Jennifer K., et al. “It's not you, It's me: The influence of patient and surgeon gender on patient satisfaction scores.Am J Surg, vol. 220, no. 5, Nov. 2020, pp. 1179–88. Pubmed, doi:10.1016/j.amjsurg.2020.07.036.
URI
https://scholars.duke.edu/individual/pub1457142
PMID
32847689
Source
pubmed
Published In
Am J Surg
Volume
220
Published Date
Start Page
1179
End Page
1188
DOI
10.1016/j.amjsurg.2020.07.036

Nucleic-Acid Scavengers Mitigate Breast Cancer Induced Inflammation, Invasion, and Metastasis

Authors
Eteshola, EOU; Landa, K; Rempel, RE; Naqvi, IA; Hwang, ES; Nair, SK; Sullenger, BA
URI
https://scholars.duke.edu/individual/pub1471025
Source
ssrn

Inferring the evolutionary dynamics of ductal carcinoma in situ through multi-regional sequencing and mathematical modeling.

Authors
Ryser, MD; Sorribes, IC; Greenwald, M; Wu, E; Hall, A; Mallo, D; King, LM; Hardman, T; Simpson, L; Maley, CC; Marks, JR; Shibata, D; Hwang, ES
MLA Citation
URI
https://scholars.duke.edu/individual/pub1467191
Source
wos-lite
Published In
Cancer Research
Volume
80
Published Date

A medicare-based comparative mortality analysis of active surveillance in older women with DCIS.

Over 97% of individuals diagnosed with ductal carcinoma in situ (DCIS) will choose to receive guideline concordant care (GCC), which was originally designed to treat invasive cancers and is associated with treatment related morbidity. An alternative to GCC is active surveillance (AS) where therapy is delayed until medically necessary. Differences in mortality risk between the two approaches in women age 65+ are analyzed in this study. SEER and Medicare information on treatment during the first year after diagnosis was used to identify three cohorts based on treatment type and timing: GCC (N = 21,772; immediate consent for treatment), AS1 (N = 431; delayed treatment within 365 days), and AS2 (N = 205; no treatment/ongoing AS). A propensity score-based approach provided pseudorandomization between GCC and AS groups and survival was then compared. Strong influence of comorbidities on the treatment received was observed for all age-groups, with the greatest burden observed in the AS2 group. All-cause and breast-cancer-specific mortality hazard ratios (HR) for AS1 were not statistically different from the GCC group; AS2 was associated with notably higher risk for both all-cause (HR:3.54; CI:3.29, 3.82) and breast-cancer-specific (HR:10.73; CI:8.63,13.35) mortality. Cumulative mortality was substantially higher from other causes than from breast cancer, regardless of treatment group. Women managed with AS for DCIS had higher all-cause and breast-cancer-specific mortality. This effect declined after accounting for baseline comorbidities. Delays of up to 12 months in initiation of GCC did not underperform immediate surgery.
Authors
Akushevich, I; Yashkin, AP; Greenup, RA; Hwang, ES
MLA Citation
Akushevich, Igor, et al. “A medicare-based comparative mortality analysis of active surveillance in older women with DCIS.Npj Breast Cancer, vol. 6, no. 1, Oct. 2020, p. 57. Pubmed, doi:10.1038/s41523-020-00199-0.
URI
https://scholars.duke.edu/individual/pub1468769
PMID
33298917
Source
pubmed
Published In
Npj Breast Cancer
Volume
6
Published Date
Start Page
57
DOI
10.1038/s41523-020-00199-0

Disparities at the Intersection of Race and Ethnicity: Examining Trends and Outcomes in Hispanic Women With Breast Cancer.

PURPOSE: We sought to examine tumor subtype, stage at diagnosis, time to surgery (TTS), and overall survival (OS) among Hispanic patients of different races and among Hispanic and non-Hispanic (NH) women of the same race. METHODS: Women 18 years of age or older who had been diagnosed with stage 0-IV breast cancer and who had undergone lumpectomy or mastectomy were identified in the National Cancer Database (2004-2014). Tumor subtype and stage at diagnosis were compared by race/ethnicity. Multivariable linear regression and Cox proportional hazards modeling were used to estimate associations between race/ethnicity and adjusted TTS and OS, respectively. RESULTS: A total of 44,374 Hispanic (American Indian [AI]: 79 [0.2%]; Black: 1,011 [2.3%]; White: 41,126 [92.7%]; Other: 2,158 [4.9%]) and 858,634 NH women (AI: 2,319 [0.3%]; Black: 97,206 [11.3%]; White: 727,270 [84.7%]; Other: 31,839 [3.7%]) were included. Hispanic Black women had lower rates of triple-negative disease (16.2%) than did NH Black women (23.5%) but higher rates than did Hispanic White women (13.9%; P < .001). Hispanic White women had higher rates of node-positive disease (23.2%) versus NH White women (14.4%) but slightly lower rates than Hispanic (24.6%) and NH Black women (24.5%; P < .001). Hispanic White women had longer TTS versus NH White women regardless of treatment sequence (adjusted means: adjuvant chemotherapy, 42.71 v 38.60 days; neoadjuvant chemotherapy, 208.55 v 201.14 days; both P < .001), but there were no significant racial differences in TTS among Hispanic patients. After adjustment, Hispanic White women (hazard ratio, 0.77 [95% CI, 0.74 to 0.81]) and Black women (hazard ratio, 0.75 [95% CI, 0.58 to 0.96]) had improved OS versus NH White women (reference) and Black women (hazard ratio, 1.15 [95% CI, 1.12 to 1.18]; all P < .05). CONCLUSION: Hispanic women had improved OS versus NH women, but racial differences in tumor subtype and nodal stage among Hispanic women highlight the importance of disaggregating racial/ethnic data in breast cancer research.
Authors
Champion, CD; Thomas, SM; Plichta, JK; Parrilla Castellar, E; Rosenberger, LH; Greenup, RA; Hyslop, T; Hwang, ES; Fayanju, OM
MLA Citation
Champion, Cosette D., et al. “Disparities at the Intersection of Race and Ethnicity: Examining Trends and Outcomes in Hispanic Women With Breast Cancer.Jco Oncol Pract, Oct. 2020, p. OP2000381. Pubmed, doi:10.1200/OP.20.00381.
URI
https://scholars.duke.edu/individual/pub1462132
PMID
33026950
Source
pubmed
Published In
Jco Oncol Pract
Published Date
Start Page
OP2000381
DOI
10.1200/OP.20.00381