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 847.733.3695 fax This location is wheelchair accessible.
B

NorthShore Medical Group

2650 Ridge Ave.
Kellogg Cancer Center
Evanston, IL 60201
847.570.1700 847.733.3695 fax This location is wheelchair accessible.

Insurance

Commercial Plans
  • Aetna Choice POS (Open Access) and POS II (Open Access)
  • Aetna Elect Choice EPO and EPO Open Access
  • Aetna Health Network Options
  • Aetna HMO (including Open Access)
  • Aetna Managed Choice (Open Access)
  • Aetna Managed Choice POS
  • Aetna Open Access Aetna Select (Aetna HealthFund)
  • Aetna Open Access Elect Choice EPO (Aetna HealthFund)
  • Aetna Open Access Managed Choice POS (Aetna HealthFund)
  • Aetna Open Choice PPO
  • Aetna Open Choice PPO (Aetna HealthFund)
  • Aetna Premier Care Network
  • Aetna QPOS
  • Aetna Select
  • Aetna Select (Open Access)
  • Beechstreet PPO Network
  • Blue Cross Blue Shield - PPO Products
    Not Contracted Blue Cross Blue Shield Blue Choice PPO
  • Blue Cross Blue Shield Blue Advantage
    Verify PCP Participation
  • 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
  • Not Contracted Aetna
  • Blue Cross Blue Shield - PPO Products
    Not Contracted Blue Cross Blue Shield Blue Choice PPO
  • Blue Cross Blue Shield Blue Precision
    Verify PCP Participation
  • Not Contracted Coventry
  • Humana National
  • Land of Lincoln - All Products
  • 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/Open Access 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

  • 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 Mar 26

    Authors: Yao K,
    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]
  • A Contemporary Analysis of Surgical Trends in the Treatment of Squamous Cell Carcinoma of the Oropharynx from 1998 to 2012: A Report from the National Cancer Database.

    Annals of surgical oncology 2015 Apr 17

    Authors: Liederbach E,
    Abstract
    This study examined surgical trends for oropharynx squamous cell carcinoma (OPC) from 1998 to 2012, with a post-2009 focus coinciding with the Food and Drug Administration (FDA) approval of transoral robotic surgery (TORS).
    Using the National Cancer Data Base, the study analyzed 84,449 patients with stage I-IVB OPC. χ (2) tests and logistic regression models were used to examine surgical trends.
    The use of surgery decreased from 41.4 % in 1998 to 30.4 % in 2009 (p < 0.001). The surgical trends reversed and in 2012 increased to 34.8 % (p < 0.001). There was much variation in surgery in 2012 between American Joint Committee on Cancer stages, with 80.2 % of stage I patients receiving surgery compared with 54.0 % of stage II patients, 36.8 % of stage III patients, and 28.5 % of stage IV patients (p < 0.001). Black patients with high socioeconomic status (SES) showed lower use of surgery (25.3 %) compared to low SES white (32.3 %) and low SES Hispanic patients (27.3 %) (p < 0.001). The highest surgical rates were noted in the West North Central region and lowest rates were observed in the New England and South Atlantic regions. Between 2009 and 2012, independent predictors of surgical treatment included young age, female gender, white or Hispanic race, high SES, private insurance, academic hospitals, hospitals in the West North Central region, residence more than 75 miles from the hospital, increasing comorbidities, stage I disease, and tonsil origin (all p < 0.05).
    Since FDA approval of TORS in 2009, surgical rates have increased with multiple socioeconomic and regional factors affecting patient selection. This study provides a basis for further investigation into factors involved in decision making for OPC patients.
    PMID: 25893414 [PubMed - as supplied by publisher]
  • Use of Postmastectomy Radiotherapy and Survival Rates for Breast Cancer Patients with T1-T2 and One to Three Positive Lymph Nodes.

    Annals of surgical oncology 2015 Mar 28

    Authors: Huo D,
    Abstract
    The effectiveness of postmastectomy radiotherapy (PMRT) in terms of survival for breast cancer patients with American Joint Committee on Cancer (AJCC) pT1-2 and one to three tumor positive lymph nodes is controversial, especially in this era of more effective systemic treatment.
    Using data from the National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) program between 1998 and 2008, this study respectively identified 93,793 and 36,299 women with AJCC pT1-2pN1 breast cancer who underwent mastectomy. The association of PMRT use with overall and cause-specific survival was examined using multivariable Cox models in subgroups defined by tumor stage.
    In the NCDB cohort, 21.5 % of the patients (n = 20,236) received PMRT, and a very similar percentage (21.9 %, n = 7939) received PMRT in the SEER cohort. In the NCDB cohort, PMRT was associated with a 14 % relative risk reduction in all-cause mortality among the patients with two positive lymph nodes and tumors 2-5 cm in size or three positive nodes [hazard ratio (HR), 0.86; 95 % confidence interval (CI), 0.81-0.91; p < 0.0001], but PMRT had no beneficial effect for the patients with one positive node or two positive nodes and tumors 2 cm in size or smaller. Analysis of the SEER cohort confirmed this heterogeneous effect, showing PMRT to be associated with a 14 % relative risk reduction in breast cancer cause-specific mortality among the patients with two positive nodes and tumors 2-5 cm in size or three positive nodes (HR 0.86; 95 % CI 0.77-0.96; p = 0.007) but not in the other subgroup.
    The effectiveness of radiotherapy depends on the combination comprising the number of positive lymph nodes and tumor size, which may enable more precise patient selection for PMRT.
    PMID: 25820998 [PubMed - as supplied by publisher]
  • Advanced age is a predictor of 30-day complications after autologous but not implant-based postmastectomy breast reconstruction.

    Plastic and reconstructive surgery 2015 Feb

    Authors: Butz DR,
    Abstract
    Older breast cancer patients undergo postmastectomy breast reconstruction infrequently, in part because of a perception of increased surgical risk. This study sought to investigate the effects of age on perioperative complications after postmastectomy breast reconstruction.
    The American College of Surgeons National Surgery Quality Improvement Program Participant Use Files from 2005 to 2012 were used to identify women with breast cancer who underwent unilateral mastectomy alone or with immediate reconstruction. Thirty-day complication rates were compared between younger (<65 years) and older (≥65 years) women after implant-based reconstruction, autologous reconstruction, or mastectomy alone. Linear and logistic regression models were used to control for differences in comorbidities and age.
    A total of 40,769 patients were studied, of whom 15,093 (37 percent) were aged 65 years or older. Breast reconstruction was performed in 39.5 percent of younger and 10.7 percent of older women. The attributable risks of breast reconstruction, manifested by longer hospital stays (p < 0.001), more frequent complications (p < 0.001), and more reoperations (p < 0.001), were similar in older and younger women. There were no differences in the adjusted complication rates between older and younger patients undergoing implant-based reconstruction. However, older women undergoing autologous reconstruction were more likely to suffer venous thromboembolism (OR, 3.67; p = 0.02).
    The perioperative risks attributable to breast reconstruction are similar in older and younger women. Older patients should be counseled that their age does not confer an increased risk of complications after implant-based breast reconstruction. However, age is an independent risk factor for venous thromboembolism after autologous reconstruction. Special attention should be paid to venous thromboembolism prophylaxis in this group.
    Risk, II.
    PMID: 25626808 [PubMed - as supplied by publisher]
  • The quality-of-life benefits of breast reconstruction do not diminish with age.

    Journal of surgical oncology 2015 May

    Authors: Sisco M,
    Abstract
    Older women rarely receive post-mastectomy breast reconstruction (PMBR). While there is a perception that PMBR is less beneficial in this age group, quality-of-life (QOL) data related to PMBR in older women remain scarce.
    Women with AJCC stage 0-III breast cancer who underwent a mastectomy were surveyed. Respondents included 215 older women (≥65 years), of whom 36.0% received PMBR, and a control group of 101 younger women (<65 years), all of whom received PMBR. Patient-reported outcomes were measured using the Duke Health Profile and the BREAST-Q.
    The survey response rate was 74.9%. An age-matched comparison of older women with and without PMBR revealed no significant differences in physical health, anxiety, or depression scores; however, PMBR was associated with greater breast satisfaction (P = 0.002) and greater breast-related psychosocial well-being (P= 0.02) than mastectomy alone. Among those who received PMBR, there was no correlation between age and breast satisfaction, psychosocial well-being, nor satisfaction with the outcome (P = 0.11, 0.21, and 0.56).
    Older women who undergo PMBR have better breast-related QOL outcomes than those who do not. Moreover, the outcomes of PMBR in older women are similar to those seen in younger women. When appropriate, older women should be encouraged to consider PMBR. J. Surg. Oncol. 2015 111:663-668. © 2015 Wiley Periodicals, Inc.
    PMID: 25560083 [PubMed - as supplied by publisher]
  • Repeat surgery after breast conservation for the treatment of stage 0 to II breast carcinoma: a report from the National Cancer Data Base, 2004-2010.

    JAMA surgery 2014 Dec

    Authors: Wilke LG,
    Abstract
    Although complete excision of breast cancer is accepted as the best means to reduce local recurrence and thereby improve survival, there is currently no standard margin width for breast conservation surgery. As a result, significant variability exists in the number of additional operations or repeat surgeries patients undergo to establish tumor-negative margins.
    To determine the patient, tumor, and facility factors that influence repeat surgery rates in US patients undergoing breast conservation surgery.
    Patients diagnosed as having breast cancer at a Commission on Cancer accredited center from January 1, 2004, through December 31, 2010, and identified via the National Cancer Data Base, a large observational database, were included in the analysis. A total of 316,114 patients with stage 0 to II breast cancer who underwent initial breast conservation surgery were studied. Patients who were neoadjuvantly treated or whose conditions were diagnosed by excisional biopsy were excluded.
    Patient, tumor, and facility factors associated with repeat surgeries.
    A total of 241,597 patients (76.4%) underwent a single lumpectomy, whereas 74,517 (23.6%) underwent at least 1 additional operation, of whom 46,250 (62.1%) underwent a completion lumpectomy and 28,267 (37.9%) underwent a mastectomy. The proportion of patients undergoing repeat surgery decreased slightly during the study period from 25.4% to 22.7% (P < .001). Independent predictors of repeat surgeries were age, race, insurance status, comorbidities, histologic subtype, estrogen receptor status, pathologic tumor size, node status, tumor grade, facility type and location, and volume of breast cancer cases. Age was inversely associated with repeat surgery, decreasing from 38.5% in patients 18 to 29 years old to 16.5% in those older than 80 years (P < .001). In contrast, larger tumor size was linearly associated with a higher repeat surgery rate (P < .001). Repeat surgeries were most common at facilities located in the Northeast region (26.5%) compared with facilities in the Mountain region, where only 18.4% of patients underwent repeat surgery (P < .001). Academic or research facilities had a 26.0% repeat surgery rate compared with a rate of 22.4% at community facilities (P < .001).
    Approximately one-fourth of all patients who undergo initial breast conservation surgery for breast cancer will have a subsequent operative intervention. The rate of repeat surgeries varies by patient, tumor, and facility factors and has decreased slightly during the past 6 years.
    PMID: 25390819 [PubMed - as supplied by publisher]
  • Wait times for breast surgical operations, 2003-2011: a report from the National Cancer Data Base.

    Annals of surgical oncology 2015 Mar

    Authors: Liederbach E,
    Abstract
    Few large-scale multicenter studies have examined wait times for breast surgery and no benchmarks exist.
    Using the National Cancer Data Base, we analyzed time from diagnosis to first surgery for 819,175 non-neoadjuvant AJCC stage 0-III breast cancer patients treated from 2003 to 2011. Chi-square tests and logistic regression models were used to examine factors associated with delays to surgery and adjuvant chemotherapy.
    Seventy percent of patients underwent an initial lumpectomy (LP), 22% a mastectomy (MA), and 8% a mastectomy with reconstruction (MR). The median time from diagnosis to first surgery significantly increased by approximately 1 week for all three procedures over the study period. In a multivariate analysis, the following variables were independent predictors of a longer wait time to first surgery: increasing age, black or Hispanic race, Medicaid or no insurance, low-education communities and metropolitan areas, increasing comorbidities, stage 0 and grade 1 disease, academic/research facilities, high-volume facilities, and facilities located in the New England, Mid-Atlantic, and Pacific regions. In 2010-2011, patients who waited >30 days for surgery were 1.36 times more likely (OR = 1.36, 95% CI 1.30-1.43) to experience a delay to adjuvant chemotherapy >60 days compared with patients who were surgically treated within 30 days of diagnosis.
    Facility and socioeconomic factors are most strongly associated with longer wait times for breast operations, and delays to surgery are associated with delays to adjuvant chemotherapy initiation.
    PMID: 25234018 [PubMed - as supplied by publisher]
  • Contralateral prophylactic mastectomy provides no survival benefit in young women with estrogen receptor-negative breast cancer.

    Annals of surgical oncology 2014 Oct

    Authors: Pesce C,
    Abstract
    Several studies have shown that contralateral prophylactic mastectomy (CPM) provides a disease-free and overall survival (OS) benefit in young women with estrogen receptor (ER)-negative breast cancer. We utilized the National Cancer Data Base to evaluate CPM's survival benefit for young women with early -stage breast cancer in the years that ER status was available.
    We selected 14,627 women ≤45 years of age with American Joint Committee on Cancer stage I-II breast cancer who underwent unilateral mastectomy or CPM from 2004 to 2006. Five-year OS was compared between those who had unilateral mastectomy and CPM using the Kaplan-Meier method and Cox regression analysis.
    A total of 10,289 (70.3 %) women underwent unilateral mastectomy and 4,338 (29.7 %) women underwent CPM. Median follow up was 6.1 years. After adjusting for patient age, race, insurance status, co-morbidities, year of diagnosis, ER status, tumor size, nodal status, grade, histology, facility type, facility location, use of adjuvant radiation and chemohormonal therapy, there was no difference in OS in women <45 years of age who underwent CPM compared towith those who underwent unilateral mastectomy (hazard ratio [HR] = 0.93; p = 0.39). In addition, Tthere was no improvement in OS in women <45 years of age with T1N0 tumors who underwent CPM versus unilateral mastectomy (HR = 0.85; p = 0.37) after adjusting for the aforementioned factors. Among women ≤45 years of age with ER-negative tumors who underwent CPM, there was no improvement in OS compared with women who underwent unilateral mastectomy (HR = 1.12; p = 0.32) after adjusting for the same aforementioned factors.
    CPM provides no survival benefit to young patients with early-stage breast cancer, and no benefit to ER-negative patients. Future studies with longer follow-up are required in this cohort of patients.
    PMID: 25081341 [PubMed - as supplied by publisher]
  • Nipple-sparing mastectomy in BRCA1/2 mutation carriers: an interim analysis and review of the literature.

    Annals of surgical oncology 2015 Feb

    Authors: Yao K,
    Abstract
    There are few large-scale studies that have examined outcomes for BRCA1/2 carriers who have undergone nipple-sparing mastectomy (NSM). The objective of our study was to examine incidental cancers, operative complications, and locoregional recurrences in BRCA1/2 mutation carriers who underwent NSM for both risk reduction and cancer treatment.
    This was a retrospective review of pathology results and outcomes of 201 BRCA1/2 carriers from two different institutions who underwent NSM from 2007 to 2014.
    NSM was performed in 397 breasts of 201 BRCA1/2 carriers. One hundred and twenty-five (62.2 %) patients had a BRCA1 mutation and 76 (37.8 %) had a BRCA2 mutation; 150 (74.6 %) patients underwent NSM for risk reduction and 51 (25.4 %) for cancer. Incidental cancers were found in four (2.7 %) of the 150 risk-reduction patients and two (3.9 %) of the 51 cancer patients. The nipple-areolar complex (NAC) was involved with cancer in three (5.8 %) patients. No prophylactic mastectomy had a positive NAC margin. There was loss of the NAC in seven breasts (1.8 %) and flap necrosis in ten (2.5 %) breasts. With a mean follow-up of 32.6 months (1-76 months), there have been four cancer events-three in cancer patients and one in a risk-reduction patient but none at the NAC.
    NSM in BRCA1/2 carriers is associated with a low rate of complications and locoregional recurrence but these patients require long-term follow-up in both the cancer and risk-reduction setting.
    PMID: 25023546 [PubMed - as supplied by publisher]
  • Changing surgical trends in young patients with early stage breast cancer, 2003 to 2010: a report from the National Cancer Data Base.

    Journal of the American College of Surgeons 2014 Jul

    Authors: Pesce CE,
    Abstract
    Young patients with breast cancer represent a unique cohort of patients who often have different treatment plans than older patients. We hypothesized that the rates of contralateral prophylactic mastectomy (CPM) were significantly higher and those of lumpectomy were significantly lower in young patients compared with older patients and that this trend persists when adjusting for patient, tumor, and facility factors.
    We used the National Cancer Data Base (NCDB) to study 553,593 patients from all ages with American Joint Committee on Cancer (AJCC) stage 0 to II breast tumors, who underwent lumpectomy, unilateral mastectomy, or CPM from 2003 to 2010.
    Over the entire cohort, lumpectomy rates decreased from 67.7% in 2003 to 66.4% in 2010 in contrast to women 45 years old or less, in whom the lumpectomy rates went from 61.3% in 2003 to 49.4% in 2010. Unilateral mastectomy went from 28.2% to 23.9% and CPM from 4.1% to 9.7% compared with women 45 years old or less, in whom unilateral mastectomy rates went from 29.3% to 26.4% and CPM rates from 9.3% to 26.4%. Age was the most significant factor related to increasing CPM rates: 19.7% of women between 41 and 45 years old underwent CPM vs 5.1% of women between 66 and 70 years old. There was substantial regional variation in surgical procedures for young women: lumpectomy rates were lowest in the West and CPM rates were highest in the Midwest. Multivariate logistic regression showed that women 45 years old or younger compared with women more than 45 years who underwent CPM were more likely to be Caucasian, treated at an academic/research institution, have larger tumors, higher grade, higher stage, and lobular histology.
    The rate of CPM continues to increase, with one-quarter of younger women undergoing CPM. This trend persists across all patient, tumor, and facility characteristics.
    PMID: 24862886 [PubMed - as supplied by publisher]

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