Spotlight on Dr. Katharine Armstrong

St. Joseph’s/Candler Breast Surgeon Dr. Katharine Armstrong offers oncoplastic technique for the best possible outcome for breast cancer patients

SJ/C: What made you decide to become a doctor?

I did not grow up wanting to be a doctor. Most of my family members were teachers, and I thought I’d be a Spanish teacher for a long time. When I was a junior in high school, I took AP biology. Honestly, I only took the class because my brother had taken it, and I wanted to do everything he did. To my surprise, I fell in love with it. I couldn’t stop telling my mom everything I was learning in school. I became really interested in anatomy and the human body. At the same time, I had family members that were dealing with different medical issues. That was the first time I had ever been exposed to the medical system and doctors. After seeing the impact physicians could have on a patient and their family, I started to think that this profession would be something I would really enjoy, and I never looked back after that.

SJ/C: Why did you decide to become a breast surgeon?

When I started medical school, I actually wanted to pursue pediatrics or pediatric oncology. However, I fell in love with surgery as a third-year medical student and shifted gears. After spending time on a breast surgery service as a second-year resident, everything clicked. It was the first time since starting residency that I saw someone – my eventual mentor, Dr. Jessica Maxwell – and thought, ‘I really think I can do that.’

It was the right combination of everything I enjoyed about medicine and patient care. With the many advancements and treatments we have these days, there is a lot of hope in breast oncology. We treat people now with the expectation that they are going to live for many years, and we pay attention to their quality of life when we make decisions about their care. 

SJ/C: Do you only treat breast cancers or are their other conditions you treat?

I treat mostly breast cancer, but I also treat benign conditions of the breast. Additionally, I treat women who are at high risk of breast cancer whether that’s due to their family history, a genetic mutation or high-risk lesions found on biopsies.

SJ/C: How do you use technology when it comes to breast surgery?

One thing I am very passionate about is oncoplastic breast surgery. When I was a medical student, the only breast surgery I knew was a flat closure mastectomy. When I was a resident, I saw people having lumpectomies while simultaneously undergoing a breast reduction or lift. This was the first time I heard the term “oncoplastics.” My mentors introduced me to a surgeon named Mel Silverstein whom many consider to be American godfather of oncoplastics. He really changed the way many of us, myself included, think about breast cancer from a surgical standpoint.

I was fortunate that the people who trained me and encouraged me to pursue breast surgery as a career always employed an oncoplastic mindset. ‘How can we approach this patient in such a way that we minimize the scarring and cosmetic deformity that can happen as a result of breast surgery?’ ‘How do we optimize both their oncologic and aesthetic outcomes ?’ I try to bring this mindset to my practice now. Whether I utilize certain techniques on my own or I partner with a plastic surgeon, I am always trying to “think oncoplastically” when I can.

SJ/C: What do you see in the future for treating breast cancer?

I think we will continue to work to maximize someone’s oncologic outcome while trying to minimize as best we can the toxicity of their treatment. Whether it’s surgery, radiation, or systemic therapy, we really try to tailor our treatment to the individual patient and tumor. I think that will continue to be the trend going forward.

Dr. Silverstein wrote a paper called “From Radical Mastectomy to Radical Conservation: Extreme Oncoplasty.” I actually have every medical student that rotates with me read this paper. In the paper, he talks about his career starting in the 1960s when there was one treatment for breast cancer: a radical mastectomy. This involves removal of the entire breast, the underlying muscle, and all of the axillary lymph nodes. He then discusses how breast cancer treatment has evolved over the last 50 years and how radically different our approach is today.  We now have so many options we can offer based on the patient, the individual tumor size, the biology of the tumor, etc. I think it’s a really exciting time to be a breast cancer specialist.

SJ/C: What is some common advice you’d share with women for their overall health?

Get your mammograms yearly. Early detection saves lives, and it changes the treatments we can offer a patient. Additionally, do your self-breast exams. Lastly, know your family history.

Family: I have an older brother, sister-in-law and three little nephews, and my parents. They are all in Atlanta. I also have a dog named Travis, a lab mix.
Hobbies: I love music – going to concerts, singing and live music