Dr. Amanda J. Wheeler is a board certified surgeon who specializes in the surgical management of breast cancer.
She completed her general surgical residency at Stanford University. To further her career in the treatment of breast cancer she was awarded a Surgical Society of Oncology accredited fellowship in Breast Surgical Oncology at the Harvard affiliated hospitals; Dana Farber Cancer Institute, Brigham and Women’s Hospital and Massachusetts General Hospital. She is actively involved in clinical research and serves on the Education Committee for the American Society of Breast Surgeons. Her main passion is improving the patient experience and patient decision making. Her published research includes; the impact of screening mammography on the morbidity and mortality of breast cancer, utilization of breast MRI, the link between obesity and breast cancer and risk factors among the African American population for breast cancer. She has also written multiple chapters in leading textbooks and collaborated with other nationally recognized experts at MD Anderson, Memorial Sloan Kettering, Stanford University and Harvard University.
She is the current surgical medical director for the Clinical Advice Service Line at Stanford Hospital and Clinics. She collaborates with the department of anesthesia and radiology to improve patient outcomes in breast surgery. She is currently working on decreasing post operative pain and immobility following breast surgery and using augmented reality intra operatively for tumor localization.
Dr. Wheeler previously was the Medical Director of the Meridian Park Legacy Breast Cancer Program and was in private practice in Portland, Oregon for five years before returning to Stanford. She enjoys playing golf, painting and yoga.
- Cancer > Breast Cancer
- General Surgery
- oncoplastic surgery
- hi risk breast cancer
- young women with breast cancer
Clinical Associate Professor, Surgery - General Surgery
President, Co-Founder, Stanford Surgical Alumni Association (2014 - Present)
Department of Surgery Representative, Clinical Educator Dean's Task Force (2015 - 2016)
Committee Member, Women's Cancer Center Breast Transformation Committee (2016 - 2017)
Committee Member, SCPSS Wellness Committee (2016 - Present)
Program Director, San Francisco Surgical Society (2016 - 2017)
Medical Director, Clinical Advice Services, Stanford Hospital and Clinics (2016 - Present)
Education Committee, American Society of Breast Surgeons (2009 - Present)
Honors & Awards
Member, Order of Omega
Member, Golden Key National Honor Society
Member, Phi Beta Kappa
Boards, Advisory Committees, Professional Organizations
Member, American Society of Breast Surgeons (2009 - Present)
Member, American Society of Breast Diseases (2009 - Present)
Member, American Society of Clinical Oncology (2009 - Present)
Member, American College of Surgeons (2008 - Present)
Fellowship, Harvard Cancer Institute: MGH, BWH, Dana Farber Cancer Institute, Breast Surgical Oncology (2009)
Board Certification: General Surgery, American Board of Surgery (2008)
Residency:Stanford Hospital and Clinics - Dept of Surgery (2008) CA
Internship:Maricopa Medical Center (2003) AZ
Medical Education:Oregon Health Science University (2002) OR
Community and International Work
Co-Chair, Stanford University
Alpha Chi Omega
female stanford university
Opportunities for Student Involvement
Current Research and Scholarly Interests
Dr. Wheeler actively participates in both clinical and basic science research in order to create opportunities for her patients to optimize their care and treatment of breast cancer. By focusing on patient centric research, she is able to offer cutting edge therapies for her breast cancer patients. She currently collaborates with several basic science labs, including Dr. Jeffrey who studies circulating tumor cells and the tumor microenvironment. Dr. Wheeler has also collaborated with Dr. Quake’s lab looking at an early detection blood test for the diagnosis of breast cancer.
As a clinical educator, Dr. Wheeler is able to choose applicable studies for her patients that have the potential to impact future patients who are diagnosed with breast cancer. Past and current projects include a patient decision making study looking at motivating factors for patients who choose mastectomy vs breast conserving surgery. She also was a co-author on a study showing a novel intra operative warming device that led to a decrease in post-operative complications. She has collaborated with a psychologist to study a surgical success program with the goal of decreasing post-operative pain and disability.
Dr. Wheeler has also collaborated with her breast imaging colleagues to develop an augmented reality platform for tumor localization with the hopes of decreasing re-excision rates and performing an improved cosmetic outcome for breast cancer patients. She also participated in a study that tattooed sentinel lymph nodes in the pre chemotherapy setting in order to limit surgery in the axilla thereby decreasing lymphedema and pain associated with standard axillary lymph node dissections.
In addition to her clinical research, she is involved nationally in breast fellowship accreditation through the American Society of Breast Surgeons(ASBS). She serves on the Education board for ASBS and is invited to give talks nationally and internationally on her clinical interests and research. She has written several chapters and is a frequent peer review editor.
At Stanford Hospital and Clinics she is the surgical medical director of Clinical Advice Services (CAS). CAS is responsible for after hour patient related triage. She is the current co-chairwoman of professional development at a fraternal organization on the Stanford Campus. Mentorship of women at the college, and fellowship level continues to be a passion for her. She also enjoys yoga, painting, playing tennis and golf.
A Review of Anatomy, Physiology, and Benign Pathology of the Nipple
ANNALS OF SURGICAL ONCOLOGY
2015; 22 (10): 3236-3240
The nipple and areola are pigmented areas of modified skin that connect with the underlying gland of the breast via ducts. The fairly common congenital anomalies of the nipple include inversion, clefts, and supernumerary nipples. The anatomy of the nipple areolar complex is discussed as a foundation to review anatomical variants, and the physiologic development of the nipple, including changes in puberty and pregnancy, as well as the basis of normal physiologic discharge, are addressed. Skin conditions affecting the nipple include eczema, which, while similar to eczema occurring elsewhere on the body, poses unique aspects in terms of diagnosis and treatment. This article concludes with discussion on the benign abnormalities that develop within the nipple, including intraductal papilloma and nipple adenoma.
View details for DOI 10.1245/s10434-015-4760-4
View details for Web of Science ID 000360303800014
View details for PubMedID 26242366
Performance and Practice Guideline for the Use of Neoadjuvant Systemic Therapy in the Management of Breast Cancer
ANNALS OF SURGICAL ONCOLOGY
2015; 22 (10): 3184-3190
The American Society of Breast Surgeons (ASBrS) sought to provide an evidence-based guideline on the use of neoadjuvant systemic therapy (NST) in the management of clinical stage II and III invasive breast cancer.A comprehensive nonsystematic review was performed of selected peer-reviewed literature published since 2000. The Education Committee of the ASBrS convened to develop guideline recommendations.A performance and practice guideline was prepared to outline the baseline assessment and perioperative management of patients with clinical stage II-III breast cancer under consideration for NST.Preoperative or NST is emerging as an important initial strategy for the management of invasive breast cancer. From the surgeon's perspective, the primary goal of NST is to increase the resectability of locally advanced breast cancer, increase the feasibility of breast-conserving surgery and sentinel node biopsy, and decrease surgical morbidity. To ensure optimal patient selection and efficient patient care, the guideline recommends: (1) baseline breast and axillary imaging; (2) minimally invasive biopsies of breast and axillary lesions; (3) determination of tumor biomarkers; (4) systemic staging; (5) care coordination, including referrals to medical oncology, radiation oncology, plastic surgery, social work, and genetic counseling, if indicated; (6) initiation of NST; (7) post-NST breast and axillary imaging; and (8) decision for surgery based on extent of disease at presentation, patient choice, clinical response to NST, and genetic testing results, if performed.
View details for DOI 10.1245/s10434-015-4753-3
View details for Web of Science ID 000360303800005
View details for PubMedID 26224406
Initial results with preoperative tattooing of biopsied axillary lymph nodes and correlation to sentinel lymph nodes in breast cancer patients.
Annals of surgical oncology
2015; 22 (2): 377-382
Pretreatment evaluation of axillary lymph nodes (ALNs) and marking of biopsied nodes in patients with newly diagnosed breast cancer is becoming routine practice. We sought to test tattooing of biopsied ALNs with a sterile black carbon suspension (Spot™). The intraoperative success of identifying tattooed ALNs and their concordance to sentinel nodes was determined.Women with suspicious ALNs and newly diagnosed breast cancer underwent palpation and/or ultrasound-guided fine needle aspiration or core needle biopsy, followed by injection of 0.1 to 0.5 ml of Spot™ ink into the cortex of ALNs and adjacent soft tissue. Group I underwent surgery first, and group II underwent neoadjuvant therapy followed by surgery. Identification of black pigment and concordance between sentinel and tattooed nodes was evaluated.Twenty-eight patients were tattooed, 16 in group I and 12 in group II. Seventeen cases had evidence of atypia or metastases, 8 (50 %) in group I and 9 (75 %) in group II. Average number of days from tattooing to surgery was 22.9 (group I) and 130 (group II). Black tattoo ink was visualized intraoperatively in all cases, except one case with microscopic black pigment only. Fourteen group I and 10 group II patients had black pigment on histological examination of ALNs. Sentinel nodes corresponded to tattooed nodes in all except one group I patient with a tattooed non-sentinel node.Tattooed nodes are visible intraoperatively, even months later. This approach obviates the need for additional localization procedures during axillary staging.
View details for DOI 10.1245/s10434-014-4034-6
View details for PubMedID 25164040
Right Breast Mastectomy and Reconstruction with Tissue Expander under Thoracic Paravertebral Blocks in a 12-Week Parturient.
Case reports in anesthesiology
2015; 2015: 842725-?
Paravertebral blocks are becoming increasingly utilized for breast surgery with studies showing improved postoperative pain control, decreased need for opioids, and less nausea and vomiting. We describe the anesthetic management of an otherwise healthy woman who was 12 weeks pregnant presenting for treatment of her breast cancer. For patients undergoing breast mastectomy and reconstruction with tissue expanders, paravertebral blocks offer an anesthetic alternative when general anesthesia is not desired.
View details for DOI 10.1155/2015/842725
View details for PubMedID 26229692
The diagnostic value of nipple discharge cytology: Breast imaging complements predictive value of nipple discharge cytology
JOURNAL OF SURGICAL ONCOLOGY
2012; 106 (4): 381-385
Papilloma is the most common finding associated with pathologic nipple discharge. In the absence of breast imaging abnormalities, the incidence of occult malignancy is <3%.To determine the predictive value of nipple discharge cytology in conjunction with breast imaging.Retrospective review of 160 charts; inclusion criteria of clinically pathologic nipple discharge, subsequent excisional biopsy, and absence of palpable abnormalities. Nipple discharge cytology categorized as negative, atypical, suspicious, and papillary. Breast imaging was analyzed. Preoperative tests were correlated to final surgical pathology.89 patients identified. Sixty-five had positive cytology, with a false positive rate of 32.3%. They were associated with papillomas in 52%, benign non-papillary in 33% and malignant lesions in 9% of cases. Nipple discharge cytology was positive in 69.6% of papillomas and 92% of atypical/malignant lesions; 30% had abnormal breast imaging and positive cytology. Nipple discharge cytology had a sensitivity of 74.5%, specificity of 30%, and positive predictive value of 68%. The positive predictive value increased to 85% with associated abnormal breast imaging.Nipple discharge cytology is useful in evaluating pathologic discharge. However, negative cytology with negative imaging is not enough to avoid surgery in cases of suspicious clinical presentation.
View details for DOI 10.1002/jso.23091
View details for Web of Science ID 000307550900005
View details for PubMedID 22396104
- Metastases to the breast: Alveolar soft part sarcoma in adolescents CLINICAL BREAST CANCER 2008; 8 (1): 92-93