Katharine A. Yao, M.D.

Katharine A. Yao, M.D.

Katharine A. Yao, M.D.

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Conditions & Procedures

Conditions

Breast Cancer, Melanoma

Procedures

Axillary Node Dissection, Groin Dissection for Melanoma, Nipple Sparing Mastectomy, Sentinel Node Biopsy, Surgical Oncology in Breast

General Information

Gender

Female

Affiliation

NorthShore Medical Group

Expertise

Breast Surgery

Academic Rank

Clinical Associate Professor

Languages

English

Board Certified

Surgery

Clinical Service

Surgical Oncology

Education, Training & Fellowships

Medical School

South Illinois University School of Medicine, 1994

Residency

McGaw Medical Center of Northwestern University, 2001

Fellowship

John Wayne Cancer Institute, 2003

Locations

A

NorthShore Medical Group

2650 Ridge Ave.
Suite 1155
Evanston, IL 60201
847.570.1700 847.733.5298 fax Get Directions This location is wheelchair accessible.
B

NorthShore Medical Group

2650 Ridge Ave.
Kellogg Cancer Center
Evanston, IL 60201
847.570.1700 847.733.5298 fax Get Directions This location is wheelchair accessible.

Insurance

Commercial Plans
  • Aetna Choice POS
  • Aetna Elect Choice EPO and EPO
  • Aetna Health Network Options
  • Aetna HMO
  • Aetna Managed Choice
  • Aetna Managed Choice POS
  • Aetna Open Choice PPO
  • Aetna Open Choice PPO (Aetna HealthFund)
  • Aetna QPOS
  • Aetna Select
  • Beechstreet PPO Network
  • Blue Cross Blue Shield - PPO Products
    Not Contracted Blue Cross Blue Shield Blue Choice PPO
  • Blue Cross Blue Shield Blue Advantage
  • Blue Cross Blue Shield HMOI
  • Cigna HMO
  • Cigna LocalPlus
  • Cigna Open Access Plus (OAP)
  • Cigna Open Access Plus with CareLink (OAPC)
  • Cigna POS
  • Cigna PPO
  • Cofinity PPO (an Aetna Company)
  • Coventry Health Care Elect Choice EPO
  • Coventry Health Care First Health PPO
  • Galaxy Health PPO Network
  • Great West PPO/POS
  • Healthcare's Finest Network (HFN)
  • Humana - All Commercial Plans (including Choice Care)
  • Humana - NorthShore Complete Care
  • Humana/ChoiceCare Network PPO
  • Medicare
  • Multiplan and PHCS PPO Network (Including PHCS Savility)
  • NorthShore Employee Network
  • Preferred Plan PPO
  • Three Rivers Provider PPO Network (TRPN)
  • Tricare
  • Unicare
  • United Healthcare - All Commercial Plans
    Not Contracted United Healthcare Core
    Not Contracted United Healthcare Navigate
Exchange Plans
  • Aetna Whole Health Chicago
  • Not Contracted Blue Cross Blue Shield - PPO Products
    Not Contracted Blue Cross Blue Shield Blue Choice PPO
  • Blue Cross Blue Shield Blue Precision HMO
  • Coventry (PPO)
  • Harken Health - an Affiliate of United Healthcare
    Verify physician participation and out of pocket expenses with Harken
  • Land of Lincoln Health Traditional PPO
  • Not Contracted United Healthcare Compass
Medicaid
  • Illinois Department of Public Aid (IDPA)
  • Illinicare ICP
  • Community Care Partners
Medicare Advantage Plans
  • Aetna Medicare (SM) Plan (HMO)
  • Aetna Medicare (SM) Plan (PPO)
  • Blue Cross Blue Shield Medicare Advantage PPO Plan
  • Cigna-HealthSpring Advantage HMO
  • Cigna-HealthSpring Premier HMO-POS
  • Cigna-HealthSpring Primary HMO
  • Humana Gold Plus HMO
  • Humana Gold Plus PFFS
  • HumanaChoice PPO
  • United Healthcare - All Medicare Plans
Medicare Medicaid Alignment Initiative (MMAI) Plans
  • Blue Cross Blue Shield Community
  • HealthSpring
  • Humana
  • Illinicare Health Plan
  • Meridian Complete

Publications

  • Surgery and hormone therapy trends in octogenarians with invasive breast cancer.

    American journal of surgery 2015 Dec 21

    Authors: Kantor O, Pesce C, Liederbach E, Wang CH, Winchester DJ, Yao K
    Abstract
    There has been a trend toward minimizing surgery in elderly women with estrogen receptor-positive (ER+) breast cancer.
    Using the National Cancer Data Base, we selected 95,357 women ≥80 years with invasive, ER+ breast cancer. Chi-square test and logistic regression were used to analyze trends in surgery and hormone therapy.
    From 2004 to 2012, 90% of women were treated with surgery first and 10% were treated with primary nonoperative management. Of those undergoing nonoperative management, 72% received endocrine therapy and 27% had no treatment. The rate of primary nonoperative treatment doubled from 7% in 2004 to 14% in 2012. Multivariate logistic regression adjusted for patient, facility, and tumor factors identified more advanced clinical stage, older age, African-American race, and treatment at Academic facilities as independent predictors of receiving primary nonsurgical management.
    There has been an increase over time in primary nonoperative management of ER+ breast cancer in octogenarians.
    PMID: 26768954 [PubMed - as supplied by publisher]
  • Survey of the Deficits in Surgeons' Knowledge of Contralateral Prophylactic Mastectomy.

    JAMA surgery 2015 Nov 25

    Authors: Yao K, Liederbach E, Lutfi W, Wang CH, Hou N, Karrison T, Huo D
    Abstract
    There have been few recent studies that have examined the use of postmastectomy radiotherapy (PMRT) for patients with 1-3 positive nodes.
    We utilized the National Cancer Data Base to examine trends in PMRT for 346,218 patients with Stage I-III breast cancer from 2003 to 2011. Neoadjuvant therapy cases were excluded. Log linear models examined trends in PMRT and logistic regressions were used to examine factors related to PMRT.
    The proportion of pT1-2N1 patients receiving PMRT increased from 23.9% in 2003 to 36.4% in 2011 with an annual percent change (APC) of 6.2% (P < 0.001). There were significant increases in the use of PMRT amongst patients with one (APC = 7.7%), two (APC = 6.7%), and three (APC = 4.2%) positive nodes. In 2011, 27.8%, 43.8%, and 57.8% of patients with one, two or three positive nodes underwent PMRT, respectively. The number of positive nodes and tumor size were the strongest independent predictors of PMRT in the 1-3 node group; lymphovascular invasion, invasive lobular histology, and triple negative phenotypes were also associated with PMRT use.
    PMRT for patients with pT1-2N1 disease has increased with the greatest increase seen in those with one tumor positive node. Tumor factors remain strong independent predictors of PMRT. J. Surg. Oncol. 2015;112:809-814. © 2015 Wiley Periodicals, Inc.
    PMID: 26606424 [PubMed - as supplied by publisher]
  • Molecular subtyping improves diagnostic stratification of patients with primary breast cancer into prognostically defined risk groups.

    Breast cancer research and treatment 2015 Nov

    Authors: Yao K, Goldschmidt R, Turk M, Wesseling J, Stork-Sloots L, de Snoo F, Cristofanilli M
    Abstract
    Combined use of MammaPrint and a molecular subtyping profile (BluePrint) identifies disease subgroups with marked differences in long-term outcome and response to neo-adjuvant therapy. The aim of this study was to evaluate the prognostic value of molecular subtyping using MammaPrint and BluePrint in women with early-stage breast cancer (BC) treated at US institutions following National Comprehensive Cancer Network standard guidelines. Tumor samples were collected from stage 1-2B consecutively diagnosed BC patients (n = 373) who underwent lumpectomy or mastectomy with an axillary staging procedure between 1992 and 2010 at two institutes (NorthShore University HealthSystem and Fox Chase Cancer Center) in the United States of America, with a median follow-up time of 9.5 years. MammaPrint low-risk patients had a 10-year DMFS of 96 % (95 %CI 92.8-99.4), while MammaPrint high-risk patients had a 10-year DMFS of 87 % (95 %CI 81.9-92.1) with a hazard ratio of 3.62 (95 %CI 1.38-9.50) (p = 0.005). Uni- and multivariate analyses included age, tumor size, grade, ER, and Her2; in multivariate analysis, MammaPrint reached near-significance (HR 3.01; p 0.08). When comparing BluePrint molecular subtyping with clinical stratification, the prognosis (10-year DMFS) was significantly different in 10-year DMFS between the different molecular subtypes (p < 0.001). This retrospective study with 10-year follow-up data provides valuable insight into prognosis of patients with primary BC comparing clinical with molecular subtyping. The BluePrint molecular stratification assay identifies patients with significantly different outcomes compared with standard clinical molecular stratification.
    PMID: 26424167 [PubMed - as supplied by publisher]
  • Survival Outcomes and Pathologic Features Among Breast Cancer Patients Who Have Developed a Contralateral Breast Cancer.

    Annals of surgical oncology 2015 Dec

    Authors: Liederbach E, Wang CH, Lutfi W, Kantor O, Pesce C
    Abstract
    Studies have shown that contralateral breast cancer (CBC) portends worse survival compared to unilateral breast cancer (UBC), but few studies have been conducted in the United States, and survival is usually examined from the time of CBC development.
    Utilizing the Surveillance, Epidemiology, and End Results database, we selected 83,001 newly diagnosed breast cancer patients from 1998 to 2005. The time interval between the initial cancer and CBC was used as a time-dependent variable in a Cox regression analysis to examine overall survival (OS) and disease-specific survival (DSS) between UBC and CBC.
    Overall, 2130 patients (2.6 %) developed a CBC, 47.2 % within 5 years and 52.8 % ≥5 years. Most stage I patients (61.9 %) developed a stage I CBC, and a majority of stage II patients (51.6 %) developed a stage I CBC (p < 0.001). There was a median follow-up of 8.7 years. After adjustment, patients who developed a CBC 4 years after their initial breast cancer had worse DSS compared to patients with UBC (hazard ratio 1.36, 95 % confidence interval 1.03-1.79). Those patients who developed their CBC 8 years after their initial breast cancer had improved DSS (hazard ratio 0.37, 95 % confidence interval 0.20-0.67). Similar trends were observed for OS. Similar trends for OS and DSS were observed for estrogen receptor-negative women and women <50 years old.
    Development of a CBC early is associated with worse survival, but CBC development later on is associated with improved survival. Future studies are needed that can assist physicians with how to predict whether a patient will develop a CBC early on.
    PMID: 26334294 [PubMed - as supplied by publisher]
  • Clinicopathologic features and time interval analysis of contralateral breast cancers.

    Surgery 2015 Sep

    Authors: Liederbach E, Piro R, Hughes K, Watkin R, Wang CH, Yao K
    Abstract
    We hypothesized that most contralateral breast cancers (CBCs) develop ≥5 years after the primary breast cancer (PBC) and that CBCs have more favorable tumor characteristics.
    This is a single-institution retrospective review of 323 patients who were diagnosed with CBC from 1990 to 2014. CBCs were diagnosed at least 1 year after the diagnosis of PBC. Χ(2) tests and one-way analysis of variance were used to examine the time interval and pathologic features between the PBC and CBC.
    The median time interval between the PBC and CBC was 6.2 years (average: 7.1, range: 1.01-23.0), and 189 (58.5%) patients had a time interval ≥5 years. Patients ≥70 years old developed a CBC sooner than patients <50 years (median: 4.3 vs 6.6 years, P < .001). Patients with infiltrating lobular carcinoma developed their CBC in 9.0 years versus 6.2 years for infiltrating ductal carcinoma histology (P = .028). In comparison with the PBC, a greater proportion of CBCs were stage I (50.8%), T1 (72.1%), node negative (67.5%), and estrogen receptor positive (68.7%). Of the 252 patients with available tumor size information for both cancers, only 54 (21.4%) patients developed a CBC that was >1 cm larger than their PBC, and only 25 (9.9%) patients developed a CBC that was >2 cm larger than their PBC. Only 28 of 201 (13.9%) node-negative PBCs developed a node-positive CBC.
    A majority of CBCs develop ≥5 years after the diagnosis of the PBC. CBCs have more favorable tumor characteristics than the PBC and tend to be smaller and node negative.
    PMID: 26067460 [PubMed - as supplied by publisher]
  • Variation in Contralateral Prophylactic Mastectomy Rates According to Racial Groups in Young Women with Breast Cancer, 1998 to 2011: A Report from the National Cancer Data Base.

    Journal of the American College of Surgeons 2015 Jul

    Authors: Grimmer L, Liederbach E, Velasco J, Pesce C, Wang CH, Yao K
    Abstract
    The rate of contralateral prophylactic mastectomy (CPM) for unilateral breast cancer has increased over the past decade, particularly for young women. This study investigates the impact of race and socioeconomic status (SES) on use of CPM.
    Using the National Cancer Data Base (NCDB), we selected 1,781,409 stage 0 to II unilateral breast cancer patients between 1998 and 2011. Trends in use of CPM by race and SES were analyzed using chi-square tests and logistic regression models.
    For women of all ages, rates of CPM increased, from 1.9% in 1998 to 10.2% in 2011 (p < 0.001), with higher rates in women ≤45 years old, rising from 3.7% in 1998 to 26.2% in 2011 (p < 0.001). Among young women, white women had the greatest increase in CPM from 4.3% in 1998 to 30.2% in 2011 (p < 0.001). In 2011, CPM rates were 30.2% for white, 18.5% for Hispanic, 16.5% for black, and 15.2% for Asian patients (p < 0.001). The gap in CPM use between white and minority patients persisted in every SES classification, geographic region, and facility type. On multivariate analysis, minority women were 50% less likely to undergo CPM than white women were.
    Young, white, breast cancer patients are twice as likely to undergo CPM compared with women in other racial groups, even after accounting for pathologic, patient, and facility factors. Variations in shared decision-making processes between women of different backgrounds may contribute to these trends, supporting the need for future studies investigating decision-making processes and decisional aids.
    PMID: 26047763 [PubMed - as supplied by publisher]
  • The Effect of Contralateral Prophylactic Mastectomy on Perioperative Complications in Women Undergoing Immediate Breast Reconstruction: A NSQIP Analysis.

    Annals of surgical oncology 2015 Oct

    Authors: Silva AK, Lapin B, Yao KA, Song DH, Sisco M
    Abstract
    Women with breast cancer are increasingly choosing to undergo contralateral prophylactic mastectomy (CPM) despite questionable survival benefit and limited data on added risks. Little is known about differences in perioperative complications between women who undergo bilateral mastectomy (BM) versus unilateral mastectomy (UM) with reconstruction.
    The American College of Surgeons National Surgery Quality Improvement Program Participant Use Files (2005-2013) were used to identify women with unilateral breast cancer who underwent UM or BM with reconstruction. Adjusted 30-day complications were compared between UM and BM groups using logistic regression models.
    A total of 20,501 patients were identified, of whom 35.3 % underwent BM. Of these, 84.3 % had implant reconstruction and 15.7 % had autologous reconstruction. For all women, BM was associated with longer hospital stays (adjusted odds ratio [aOR] 1.98-2.09, p < 0.001) and a higher transfusion rate than UM (aOR 2.52-3.06, p < 0.001). BM with implant reconstruction was associated with a modestly increased reoperation rate (aOR 1.15, p = 0.029). BM with autologous reconstruction was associated with a higher wound disruption rate (aOR 2.51, p = 0.015). Surgical site infections, prosthesis failure, and medical complications occurred at similar rates in UM and BM groups.
    CPM is associated with significant increases in some, but not all, surgical site complications. CPM does not increase the likelihood of medical complications, which are generally infrequent.
    PMID: 26001862 [PubMed - as supplied by publisher]
  • Advanced Age Does Not Worsen Recovery or Long-Term Morbidity After Postmastectomy Breast Reconstruction.

    Annals of plastic surgery 2016 Feb

    Authors: Johnson DB, Lapin B, Wang C, Yao K, Rasinski K, Rundell V, Sisco M
    Abstract
    Despite evidence that older women have quality-of-life outcomes similar to younger women after postmastectomy breast reconstruction (PMBR), they rarely receive it. There is a perception that PMBR in older women may result in significant physical morbidity. However, the effects of age on physical morbidity after PMBR have not been studied. This study sought to assess perceptions of recovery from surgery and long-term chest and upper body morbidity in older women who receive PMBR.
    Women with American Joint Committee on Cancer stage 0-III breast cancer who underwent a mastectomy with PMBR between 2005 and 2011 were surveyed to assess their functional health status (DUKE), physical well-being (BREAST-Q), and perceptions of recovery from surgery. Patients were stratified into 2 age groups: older (≥65 years) and younger (<65 years). Outcome scores were compared by mastectomy laterality, reconstruction type, and between age groups. Data were analyzed using χ and t tests.
    One hundred eight older and 103 younger patients returned surveys (response rate, 75.4%). The median time from mastectomy to survey was 4 years (range, 1-7). Younger women were more likely to undergo bilateral mastectomy than older women (65.7% vs 32.2%, P < 0.001). Some women (66.9%) underwent implant-only reconstruction and 33.1% underwent autologous reconstruction; there were no significant differences in reconstruction type between age groups. Patients who underwent unilateral and bilateral mastectomy had similar mean BREAST-Q physical well-being scores (79.4 vs 78.9, respectively, P = 0.85). There was no difference in mean physical well-being scores between older and younger patients (80.0 vs 78.5, respectively, P = 0.61). In addition, older patients were less likely to perceive their recovery from PMBR as being difficult than younger patients, though this was not statistically significant (48.2% vs 64.3%, P = 0.07).
    Older women who undergo PMBR have physical and upper body well-being that is similar to younger women. In addition, their perception of recovery from PMBR is at least as good as that seen in younger women. Older women contemplating PMBR should be counseled that they are not at higher risk for long-term physical and upper body morbidity from PMBR than are younger women.
    PMID: 25954837 [PubMed - as supplied by publisher]
  • Impact of the American College of Surgeons Oncology Group Z0011 Randomized Trial on the Number of Axillary Nodes Removed for Patients with Early-Stage Breast Cancer.

    Journal of the American College of Surgeons 2015 Jul

    Authors: Yao K, Liederbach E, Pesce C, Wang CH, Winchester DJ
    Abstract
    The Z0011 trial showed similar outcomes between sentinel node biopsy (SNB) alone and axillary node dissection (ALND) for early-stage breast cancer, but few studies have examined Z0011's impact on practice patterns.
    Using the National Cancer Data Base, we examined use of SNB alone in patients who did and did not fulfill Z0011 eligibility criteria from 1998 to 2011. Because the National Cancer Data Base does not specifically identify SNB vs ALND, we categorized removal of ≤4 nodes as SNB only and ≥10 nodes as ALND.
    Of 74,309 lumpectomy patients who fulfilled Z0011 criteria; 17,630 (23.7%) had a ≤4 nodes removed, 15,619 (21.0%) had 5 to 9 nodes removed, and 41,060 (55.3%) had ≥10 nodes removed. The proportion of lumpectomy patients receiving SNB increased from 6.1% in 1998 to 23.0% in 2009 to 56.0% in 2011 (p < 0.001). Independent predictors of ALND in lumpectomy patients were triple-negative tumors, younger than 50 years old, African-American race, size ≥3.0 cm, ≥2 positive nodes, invasive lobular carcinoma, grade III disease, and lymph node macrometastases. Patients outside of Z0011 criteria also underwent SNB alone: 54% of patients with tumors >5 cm, 52.5% who received no radiation therapy or accelerated partial breast irradiation, 35.9% with clinically positive nodes, 22.3% who underwent mastectomy, and 12.9% who had >3 tumor-positive nodes.
    The use of SNB alone for patients fulfilling Z0011 criteria has increased substantially from 2009 to 2011. A considerable proportion of patients falling outside of Z0011 eligibility criteria were also treated with SNB alone.
    PMID: 25899731 [PubMed - as supplied by publisher]

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