Katrina Mitchell’s passion for women’s health began while researching her senior honors thesis at Bowdoin College, a small liberal arts school in coastal Maine. As she wrote about the involuntary sterilization of Native American women, she set her post-graduation sights on a job where she could directly impact female health. She took a job at an inner-city Philadelphia women’s health center and before long, the dream of attending medical school was born. After completing the required science courses through a Bryn Mawr College post-baccalaureate program, she was accepted at Dartmouth Medical School and began the long road to becoming a fellowship-trained breast surgical oncologist with a unique and specialized focus. Katrina Mitchell, MD, IBCLC, FACS is now the second breast surgeon on the Ridley-Tree Cancer Center breast care team alongside 20-year veteran, Rosa Choi, MD, FACS.
Raised in California’s central valley, Dr. Mitchell knew that despite the expansive route taken to acquire her education and training, she would one day return to her home state. Until then, she was determined to build her skill set at top institutions. Her first exposure to surgery came during her internship and residency at New York Presbyterian/Weill Cornell Medical Center. “I liked the procedural aspects of it, the problem-solving aspects of it, and I liked that you could do it anywhere in the world,” she comments. Her residency included time spent at Memorial Sloan Kettering Cancer Center and three years of research with Cornell’s partner hospital in Tanzania, a country that has one physician per 50,000 patients. On the ground and in the villages of east Africa, Dr. Mitchell assisted with surgical education projects, helped with research on a frequently-misdiagnosed parasitic infection affecting women, volunteered as a flight surgeon for a Kenyan medical education foundation and wrote a grant for a pediatric burn unit. She witnessed how the local healthcare infrastructure was ill-equipped to deal with the many cases of surgical trauma. This experience confirmed for Dr. Mitchell that a career blending surgery and public health would suit her best. “Even within the U.S., there is a lot of inequality in healthcare and supporting women no matter their background and caring for them when they have a diagnosis is important to me,” she says. Once back on U.S. soil, Dr. Mitchell began a breast surgical oncology fellowship at MD Anderson Cancer Center in Texas, one of the best training and treatment centers in the world. She immersed herself in the latest forms of breast cancer treatment and research, and upon completion launched a new breast cancer surgery program at an MD Anderson network hospital in Albuquerque, New Mexico. This valuable clinical experience included learning to use the SAVI SCOUT® technology. Surgeons place the SCOUT, a small, wireless reflector, into the breast and then use a hand-held device that emits a signal to precisely target what needs to be removed. This often results in better cosmetic outcomes because less tissue is taken out of the breast.
The arrival of Dr. Mitchell’s son expanded her personal interest into the kinds of questions facing younger breast cancer patients, like ‘Can I continue breastfeeding?’ ‘Are all cancer treatments safe if I am breastfeeding?’ ‘If I have cancer now, could I breastfeed in the future?’ ‘Could cancer affect my fertility?’ She dove into the research on breastfeeding and cancer, and how it might affect the women she treated. A keen student of breast anatomy, she began caring for patients with complications of breastfeeding and ultimately became a lactation consultant herself. “Even with an increase in national breastfeeding rates, there is still a lot of lag in terms of medical support and education,” she stresses. “We have little education on the physiology of the breast in medical school and little if at all in residency.” To fill this gap, Dr. Mitchell developed a breastfeeding medicine course for breast surgeons that she’s offered at medical association meetings in the U.S. and abroad. “Cancer doctors need to know this when they are making decisions on surgery,” she confirms. “We know cancer really well, but we need to maintain a connection to the physiologic function.” While Dr. Mitchell readily expounds on the benefits of breastfeeding, she’s eager to know if breastmilk itself could reveal hidden information on a woman’s predisposition to breast cancer. She is partnering with the University of Massachusetts Breastmilk Lab on a Department of Defense-funded study that will examine if breast cancer and breast cancer risk can be accurately accessed from a breast milk sample.
While Memorial Sloan Kettering and MD Anderson provided Dr. Mitchell with a view of cancer research and treatment on a grand scale, she prefers the kind of personalized care offered in a smaller setting. “You can actually be much more involved in a patient’s care in a smaller location, following them every step of the way,” she explains. She’s devoted to the idea of multidisciplinary care not solely focused on surgery. “It’s about all the resources we have to care for these women. The wonderful community of people here, from the nurses to the navigators to those scheduling surgery, it’s very appealing.” For patients who require procedures, Dr. Mitchell is a firm believer they should be seeing surgeons who only do breast. “This is a nuanced, super-specialized aspect of medicine. It’s not just taking out a mass. It’s understanding what kind of breast cancer it is, whether you can do any breast preservation, whether chemotherapy should be done before or after surgery. I really value having a surgical partner who has been in practice for two decades. That experience over time is extremely helpful,” she says of Dr. Choi. For now, Dr. Mitchell is bringing her “village mindset” to town and is resigned to meet every oncologist, gynecologist, midwife, social worker, therapist, internist (and the list goes on) to surround herself with a tribe of experts on behalf of her patients. While the subject of breast cancer treatment and research can be heavy at moments, even the most serious of surgeons needs some comic relief. Dr. Mitchell’s four year-old son, Becker excels in this arena. He brings out the silly side of his physician mother and you may find them chasing each other alongside the surf at a local beach, smiling in the California sunshine and soaking in all the free goodness Santa Barbara has to offer.