Spring 2015
Teamwork, expertise give patients surgery options

synapse: University of Nevada, Reno School of Medicine

Jennifer Baynosa and John Kim

Looking for signs of cancer

Jennifer Baynosa, M.D., instructs third-year medical student John Kim on how to look for signs of breast cancer on mammograms at the Patient Care Center located in Las Vegas. Photo by Edgar Antonio Núñez.

Fellowship-trained breast oncologist one of few in Nevada

Story by Anne McMillin, APR

A School of Medicine team of surgeons collaborates to provide compassionate care to patients facing difficult decisions following a diagnosis of breast cancer.

Jennifer Baynosa, M.D., a fellowship-trained breast oncology surgeon; her husband Richard Baynosa, M.D., a plastic surgeon with training in breast reconstruction; Daniel Kirgan, M.D., chief of surgical oncology and Charles “Randy” St. Hill, M.D., a surgical oncologist, work together to develop the best possible individualized breast cancer care and treatment plans for patients.

Through this integrated approach, School of Medicine oncology surgeons work with patients and their primary care physician to determine if and when breast surgery is the best course for treatment.

Jennifer explains her role in interacting with patients as presenting the risks and benefits of their various options when given a diagnosis of breast cancer.

“I want to make them happy and give them what they want in terms of surgical options which can include mastectomy, double mastectomy and reconstruction using their own body tissue,” she said, explaining that after she surgically removes the cancer, Richard is available to reconstruct the breast.

She said that even though each member of the oncology team has his or her own expertise and training, they work well together and complement each other’s skill set for the optimal patient outcome.

“As partners, we help each other out in the operating room, review patient files and charts and consult and collaborate to get multiple points of input for a patient’s treatment. It is nice to have partners who are trained in the same discipline and are read-up on the current literature.”

Kirgan said the tandem working relationship between the plastic surgery division and the surgical oncology division is truly for the benefit of the patient.

“The surgical oncologists focus on the surgical treatment of cancer while the plastic surgeons reconstruct and rebuild following the removal of the cancer,” he said. Sometimes the reconstruction may be done at the same time as the cancer removal while other times, there are interim treatments to be performed before the patient is rescheduled for reconstructive surgery.

The School of Medicine’s surgical oncology division grew over the last seven years as both Baynosas and St. Hill were recruited to offer their expertise to the larger surgery department. While Jennifer refers her reconstruction patients to Richard, Kirgan refers his William A. Zamboni, M.D., '84, chair of the Department of Surgery, who is also a plastic surgeon.

Having two such teams essentially greatly increases the number of oncology patients seen by the department. And, according to Kirgan, the combination of the surgical skills and expertise offered by the surgical oncology and plastic surgery divisions means the School of Medicine’s Department of Surgery provides patients with options that are not readily available elsewhere in southern Nevada.

Jennifer’s patients tend to be women aged 14 to 90, although she also sees male patients with breast disease. Patients of both genders present on referral from their primary care physician following an abnormal screening test. Tumors in her patients may range in severity from small and benign to large and malignant.

She also consults with high-risk patients who have a history of family cancer and presents their options which range from medications to reduce risk to genetic screening services to surgery.

“I want my patients to be educated and understand their options and what is best for them,” she said. For those who have a genetic predisposition for breast cancer, breast removal surgery is an option.

Breast exams for patients determined to be high risk can involve twice yearly MRIs and X-ray screening starting at age 25.

“Often, these high-risk women decide to breast feed their children before having a bilateral breast removal,” Jennifer explained.

Jennifer attended the USC Keck School of Medicine, did her surgical residency at the University of Nevada School of Medicine, including a year as chief resident before completing a Komen/SSO Breast Fellowship at Stanford University.

She returned to Nevada in 2008 to join the faculty in the School of Medicine’s Department of Surgery, where, in addition to treating breast cancer patients, she currently serves as program director for the 28 general surgery residents. She sits on the School of Medicine’s Admission Selection Committee and the Year III-IV Clerkship Committee as well as the Committee on Applicants for the American College of Surgeons.

Jennifer is a fellow of the American College of Surgeons, and a member of the American Society of Breast Surgeons, the Society of Surgical Oncology, the Association of Surgical Education and the Association of Program Directors in Surgery.

Her volunteer activities have included providing free breast exams at University Medical Center and keynote speaker remarks at the East Career and Technical Academy scrub ceremony and Foothills High School’s career day.

Zamboni believes Jennifer’s skills greatly enhance his department and provide patients in southern Nevada with viable options when diagnosed with breast cancer.

“Dr. Jennifer Baynosa is one of the few fellowship-trained breast oncology surgeons in Las Vegas. Her expertise is certainly an asset to the Department of Surgery and University of Nevada School of Medicine,” he said.