Carolyn Menendez

Positions:

Assistant Professor of Surgery

Surgical Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.S. 1994

University of California at Irvine

M.D. 1998

Eastern Virginia Medical School

General Surgery Internship, Surgery

Eastern Virginia Medical School

General Surgery Residency, Surgery

University of California, San Francisco at Fresno, School of Medicine

Publications:

Transient Horner's syndrome in a trauma patient with thoracic epidural analgesia: a case report.

Authors
Menendez, C; MacMillan, DT; Britt, LD
MLA Citation
Menendez, Carolyn, et al. “Transient Horner's syndrome in a trauma patient with thoracic epidural analgesia: a case report..” The American Surgeon, vol. 66, no. 8, Waverly Press Inc, pp. 756–58.
URI
https://scholars.duke.edu/individual/pub1387940
Source
manual
Published In
Am Surg
Volume
66
Start Page
756
End Page
758

DCIS with Microinvasion: Is It In Situ or Invasive Disease?

BACKGROUND: Ductal carcinoma in situ (DCIS) with microinvasion (DCISM) can be challenging in balancing the risks of overtreatment versus undertreatment. We compared DCISM, pure DCIS, and small volume (T1a) invasive ductal carcinoma (IDC) as related to histopathology, treatment patterns, and survival outcomes. METHODS: Women ages 18-90 years who underwent breast surgery for DCIS, DCISM, or T1a IDC were selected from the SEER Database (2004-2015). Multivariate logistic regression and Cox proportional hazards models were used to estimate the association of diagnosis with treatment and survival, respectively. RESULTS: A total of 134,569 women were identified: 3.2% DCISM, 70.9% DCIS, and 25.9% with T1a IDC. Compared with invasive disease, DCISM was less likely to be ER+ or PR+ and more likely to be HER2+. After adjustment, DCIS and invasive patients were less likely to undergo mastectomy than DCISM patients (DCIS: OR 0.53, 95% CI 0.49-0.56; invasive: OR 0.86, CI 0.81-0.92). For those undergoing lumpectomy, the likelihood of receiving radiation was similar for DCISM and invasive patients but lower for DCIS patients (OR 0.57, CI 0.52-0.63). After adjustment, breast-cancer-specific survival was significantly different between DCISM and the other two groups (DCIS: HR 0.59, CI 0.43-0.8; invasive: HR 1.43, CI 1.04-1.96). However, overall survival was not significantly different between DCISM and invasive disease, whereas patients with DCIS had improved OS (HR 0.83, CI 0.75-0.93). CONCLUSIONS: Although DCISM is a distinct entity, current treatment patterns and prognosis are comparable to those with small volume IDC. These findings may help providers counsel patients and determine appropriate treatment plans.
Authors
MLA Citation
Champion, Cosette D., et al. “DCIS with Microinvasion: Is It In Situ or Invasive Disease?.” Ann Surg Oncol, vol. 26, no. 10, 2019, pp. 3124–32. Pubmed, doi:10.1245/s10434-019-07556-9.
URI
https://scholars.duke.edu/individual/pub1385699
PMID
31342393
Source
pubmed
Published In
Annals of Surgical Oncology
Volume
26
Published Date
Start Page
3124
End Page
3132
DOI
10.1245/s10434-019-07556-9

The Influence of Age on the Histopathology and Prognosis of Atypical Breast Lesions.

BACKGROUND: Although several prognostic variables and risk factors for breast cancer are age-related, the association between age and risk of cancer with breast atypia is controversial. This study aimed to compare the type of breast atypia and risk of underlying or subsequent breast cancer by age. METHODS: Adult women with breast atypia (atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ) at a single institution from 2008 to 2017 were stratified by age at initial diagnosis: <50 y, 50-70 y, and >70 y. Regression modeling was used to estimate the association of age with risk of underlying carcinoma or subsequent cancer diagnosis. RESULTS: A total of 530 patients with atypia were identified: 31.1% < 50 y (n = 165), 58.1% 50-70 y (n = 308), and 10.8% > 70 y (n = 57). The proportion of women with atypical ductal hyperplasia steadily increased with age, compared with atypical lobular proliferations (P = 0.04). Of those with atypia on needle biopsy, the overall rate of underlying carcinoma was 17.5%. After adjustment, older age was associated with a greater risk of underlying carcinoma (odds ratio: 1.028, 95% confidence interval: 1.003-1.053; P = 0.03). Of those confirmed to have atypia on surgical excision, the overall rate of a subsequent cancer diagnosis was 15.7%. Age was not associated with a long-term risk for breast cancer (P = 0.48) or the time to a subsequent diagnosis of carcinoma (log-rank P = 0.41). CONCLUSIONS: Although atypia diagnosed on needle biopsy may be sufficient to warrant surgical excision, older women may be at a greater risk for an underlying carcinoma, albeit the long-term risk for malignancy associated with atypia does not appear to be affected by age.
Authors
Sergesketter, AR; Thomas, SM; Fayanju, OM; Menendez, CS; Rosenberger, LH; Greenup, RA; Hyslop, T; Parrilla Castellar, ER; Hwang, ES; Plichta, JK
MLA Citation
Sergesketter, Amanda R., et al. “The Influence of Age on the Histopathology and Prognosis of Atypical Breast Lesions..” J Surg Res, vol. 241, Sept. 2019, pp. 188–98. Pubmed, doi:10.1016/j.jss.2019.03.047.
URI
https://scholars.duke.edu/individual/pub1381807
PMID
31028940
Source
pubmed
Published In
J Surg Res
Volume
241
Published Date
Start Page
188
End Page
198
DOI
10.1016/j.jss.2019.03.047

Germline Genetic Testing: What the Breast Surgeon Needs to Know.

PURPOSE: The American Society of Breast Surgeons (ASBrS) sought to provide educational guidelines for breast surgeons on how to incorporate genetic information and genomics into their practice. METHODS: A comprehensive nonsystematic review was performed of selected peer-reviewed literature. The Genetics Working Group of the ASBrS convened to develop guideline recommendations. RESULTS: Clinical and educational guidelines were prepared to outline the essential knowledge for breast surgeons to perform germline genetic testing and to incorporate the findings into their practice, which have been approved by the ASBrS Board of Directors. RECOMMENDATIONS: Thousands of women in the USA would potentially benefit from genetic testing for BRCA1, BRCA2, and other breast cancer genes that markedly increase their risk of developing breast cancer. As genetic testing is now becoming more widely available, women should be made aware of these tests and consider testing. Breast surgeons are well positioned to help facilitate this process. The areas where surgeons need to be knowledgeable include: (1) identification of patients for initial breast cancer-related genetic testing, (2) identification of patients who tested negative in the past but now need updated testing, (3) initial cancer genetic testing, (4) retesting of patients who need their genetic testing updated, (5) cancer genetic test interpretation, posttest counseling and management, (6) management of variants of uncertain significance, (7) cascade genetic testing, (8) interpretation of genetic tests other than clinical cancer panels and the counseling and management required, and (9) interpretation of somatic genetic tests and the counseling and management required.
Authors
Plichta, JK; Sebastian, ML; Smith, LA; Menendez, CS; Johnson, AT; Bays, SM; Euhus, DM; Clifford, EJ; Jalali, M; Kurtzman, SH; Taylor, WA; Hughes, KS
MLA Citation
Plichta, Jennifer K., et al. “Germline Genetic Testing: What the Breast Surgeon Needs to Know..” Ann Surg Oncol, vol. 26, no. 7, July 2019, pp. 2184–90. Pubmed, doi:10.1245/s10434-019-07341-8.
URI
https://scholars.duke.edu/individual/pub1379748
PMID
30941656
Source
pubmed
Published In
Annals of Surgical Oncology
Volume
26
Published Date
Start Page
2184
End Page
2190
DOI
10.1245/s10434-019-07341-8