Jamie Lewis (Host): According to the National Breast Cancer Foundation, one in every eight women in the United States will develop breast cancer in her lifetime. Fortunately, breast cancer death rates have dropped 43% over the last several decades, thanks in part to continuously improving treatment options.

Here to talk about this is Dr. Dawn Leonard, a breast surgical oncologist with Holy Cross Health. She'll share a bit about her experience and expertise, as well as modern medicine's advancements in treating breast cancer. This is Your Best Life Podcast from Holy Cross Health. I'm your host, Jamie Lewis. Dr. Leonard, thanks for being on the program.

Dr. Dawn Leonard: Thanks for having me.

Host: Let's talk a little bit about your background. How did you become a board-certified breast surgical oncologist and arrive at Holy Cross Health?

Dr. Dawn Leonard: So, that is actually an interesting story. By training, I was trained in General Surgery way back when. And my mentor as a General Surgery resident was an amazing plastic surgeon named Robert Dennis. And at the completion of residency, I was convinced that I wanted to be a plastic surgeon. I started down that pathway to a Plastic Surgery fellowship and realized that it just wasn't my calling and I wasn't excited about it. And I had to really rethink what it was about his practice and what it was about surgery that I loved. And I realized it was actually more on the acute care and immediate care side in breast cancer diagnosis and treatment. After I figured that out, I went back and did a fellowship and this is the path I've been on ever since.

And, truthfully, I feel like it's my calling, it is what I am meant to do, it is what I am destined to do, and it's been a joy doing it these past 20 years. My career has taken some interesting turns. I started out with a private practice in Frederick, Maryland, and then was recruited to go to a few hospital systems to start breast cancer programs and practices, which I did. And that's how I actually was introduced to Holy Cross Mission to develop a cancer program here.

Interestingly enough, for me, this is coming home. I was born at Holy Cross Hospital a million years ago. I grew up in Montgomery County, born and bred Maryland girl. So when we started having these conversations about what Holy Cross wants to do and what kind of care they want to provide, for me, it was a chance to come home and serve the community that has served me so well all these years.

Host: Well, that really does feel like destiny. I always like to ask, what are you passionate about outside of work?

Dr. Dawn Leonard: You know, I think we all say the same thing, family, time. I'm mostly an empty nester now, you know, all college age and older. So, being able to focus on my spouse, my kids as they've grown, being able to pursue my passions again, finally reading and cycling, even taking a nap on occasion without guilt, really service. But most importantly, I really focus and I'm passionate about living a life that's meaningful and living a life that's full of joy.

Host: Going back to your professional life as a breast surgical oncologist, what do you want people to know about your practice?

Dr. Dawn Leonard: One thing I think anybody who's worked with me in the past, and those who will work with me in the future will know is I am always smiling. I want my practice to be a place where people want to be because if we love what we do, that translates to the patient. We don't just see a diagnosis. We see a person and our goal is to treat the whole person through all aspects of their journey. Breast cancer patients come into your life and oftentimes they're in your life for many years. It's not a one and done. These are relationships that we're forming. And with every relationship, you want to make sure that you're aware of their needs, you're addressing their personality, you're supportive and you're caring. It's not just about your expert hands. It's really about your spirit as well. And that's how I want my practice to run.

Host: As I mentioned at the top, one in eight women will develop breast cancer in her lifetime, which is a daunting statistic, of course, but treatment is always improving. What advancements or developments in breast cancer treatment are you most excited about?

Dr. Dawn Leonard: Well, I think the most interesting thing is we are looking at ways to de-escalate surgical interventions that cause long-term morbidity or dysfunction. We're looking much more closely at the biology of cancer. Every breast cancer is not the same. It's not going to behave the same way in every patient. And we're really focused more and more and more on individualized care. I think in the future, they may eventually be able to phase me out as a surgeon. And breast cancer may become a disease that is largely treated with medications. In a wonderful future world, we'd have a vaccine, which would be amazing. But I know it's difficult and it's a long journey, and I'm here until they get rid of me.

Host: Well, that's a great way to look at it and to approach it. Talking more broadly, where do you see the state of oncology in, say, the next 10 years?

Dr. Dawn Leonard: As I said, I think we're going to see more and more and more about individualized medications and therapies. I think we're going to see more about immunotherapy looking at our immune system and how we can use someone's natural immune system to fight off cancer as well as other diseases. I think that's the future of cancer care. And I think it's going to be the future of breast cancer care.

If we can continue to de-escalate the need for big, huge, invasive surgeries, I think patients will have more hope and better overall cosmetic outcomes. They won't be so fearful. What's interesting about that statistic of one in eight, it's not across the board. When we look at women who are young, under the age of 50, we see higher incidence rates among African American women, and they have poor mortality. After age 50, we start seeing that incidence level out. But depending on your age, depending on your race, depending on your environment, that one in eight could actually be something more like one in four, or it could be better, one in 20. So, there's so many factors that come into play that we're becoming more aware of and we're more focused on why do we see these differences? Why do we see these disparities in this incidence rate, in these survival rates, in the success rate of treatment? And if we can figure that out and become even more individualized, I think we're going to have a greater impact.

Host: Fantastic. Well, Dr. Leonard, thank you so much for joining us.

Dr. Dawn Leonard: Absolutely. It has been my pleasure.

Host: That was Dr. Dawn Leonard, board-certified breast surgical oncologist at Holy Cross Health. To learn more, visit holycrosshealth.org. And if you found this podcast helpful, please share it on your social media channels. And for other topics of interest to you, check out our full podcast library. This is your Best Life podcast from Holy Cross Health. Thanks for listening.