Katharine A. Yao, M.D.

Katharine A. Yao, M.D.

Katharine A. Yao, M.D.

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Conditions & Procedures


Breast Cancer, Melanoma


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

General Information




NorthShore Medical Group


Breast Surgery

Academic Rank

Clinical Associate Professor



Board Certified


Clinical Service

Surgical Oncology

Education, Training & Fellowships

Medical School

South Illinois University School of Medicine, 1994


McGaw Medical Center of Northwestern University, 2001


John Wayne Cancer Institute, 2003



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.

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.


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  • Clinicopathologic features and time interval analysis of contralateral breast cancers.

    Surgery 2015 Sep

    Authors: Liederbach E,
    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,
    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 May 22

    Authors: Silva AK,
    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 2015 May 7

    Authors: Johnson DB,
    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,
    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,
    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,
    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,
    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,
    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.
    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,
    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]

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