Molecular profiling in contemporary breast cancer management

Zaborowski AM, Heeney A, Walsh S, Barry M, Kell MR. Immediate breast reconstruction. Br J Surg 2023; 110: 1039-1042. Comment: Lots of different methods: which to choose?

Malin Sund, MD, PhD

Professor of Surgery
Department of Diagnostics and Intervention
Umeå University
Sweden

Department of Surgery/CLINICUM
University of Helsinki
Finland

My name is Malin Sund. I work as professor of surgery and consultant of surgery at the University of Helsinki and Helsinki University Hospital in Finland, and as guest professor of surgery at Umeå University in Sweden. I was invited to write this piece about why I became a breast surgeon. The question is interesting since I came to realize that perhaps this was more serendipity than an active pursuit. During surgical training, I found most clinical subspecialities interesting. I am also quite sure that if I had chosen another field of surgery, I would have been equally content. Breast surgery as a subspeciality is in many ways location dependent. By this I mean that depending on the country, region and hospital you practice in, breast surgery can be performed by the general surgeon, plastic surgeon or gynaecologist. I trained and practiced for many years in Sweden, where most breast surgeons are general surgeons that subspecialize into breast surgery. My training was at the most northern university hospital in Sweden i.e. Umeå University Hospital. In Umeå, breast surgery is performed within a division of Breast, Melanoma and Endocrine surgery (dubbed the BRENDO division). This is quite a common combination in the Swedish setting outside of the biggest cities/hospitals. Since there are no paediatric surgery clinics in Sweden north of Uppsala, also elective paediatric surgery was the task of BRENDO surgeons. Therefore, when deciding upon the field of surgery to choose, I felt that BRENDO surgeons dealt with many fascinating diseases and interesting surgical procedures. Naturally, having a group of great colleagues also significantly influenced the choice! I have since transferred to Helsinki in Finland. In this setting my BRENDO diagnoses were suddenly spread out at three different hospitals and performed by three separate specialities. Thus, for practical reasons it was not possible to continue with the broader surgical repertoire, and currently my clinical work is mostly breast surgery i.e. due to being location-dependent.