Eun-Sil Hwang

Positions:

Mary and Deryl Hart Distinguished Professor of Surgery, in the School of Medicine

Surgical Oncology
School of Medicine

Professor of Surgery

Surgical Oncology
School of Medicine

Vice Chair of Research in the Department of Surgery

Surgery
School of Medicine

Professor of Radiology

Radiology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1991

University of California at Los Angeles

M.P.H. 2006

University of California at Berkeley

Intern, General Surgery

Kaiser Foundation Hospital

Resident, General Surgery

Cornell University

Fellow, Breast Surgical Oncology

Memorial Sloan Kettering Cancer Center

Senior Reigstrar, General Surgical Oncology

Singapore General Hospital

Assistant Professor in Residence, Surgery

University of California, San Francisco, School of Medicine

Associate Professor in Residence, Surgery

University of California, San Francisco, School of Medicine

Chief, Division Of Breast Surgery Oncology

University of California, San Francisco, School of Medicine

Professor in Residence, Surgery

University of California, San Francisco, School of Medicine

Surgeon-in-Chief, Ucsf Helen Diller Family Cancer Center

University of California, San Francisco, School of Medicine

Grants:

Comparing the Effectiveness of Guideline-concordant Care to Active Surveillance for DCIS: an Observational Study

Administered By
Surgical Oncology
Awarded By
Patient Centered Outcomes Research Institute
Role
Principal Investigator
Start Date
End Date

Breast Pre-Cancer Atlas Center

Administered By
Surgical Oncology
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

TBCRC 034 DFCI 15-174

Administered By
Duke Cancer Institute
Awarded By
Johns Hopkins University
Role
Principal Investigator
Start Date
End Date

Tissue tension, RANK and Breast Cancer Risk

Administered By
Surgical Oncology
Awarded By
University of California, San Francisco
Role
Principal Investigator
Start Date
End Date

CALGB 40903

Administered By
Surgical Oncology
Role
Principal Investigator
Start Date
End Date

Publications:

Unmasking the Tissue Microecology of Ductal Carcinoma In Situ with Deep Learning

Authors
Narayanan, PL; Raza, SEA; Hall, A; Marks, JR; King, L; Dowsett, M; Gusterson, B; Maley, C; Hwang, ES; Yuan, Y
MLA Citation
Narayanan, P. L., et al. “Unmasking the Tissue Microecology of Ductal Carcinoma In Situ with Deep Learning.” Journal of Pathology, vol. 249, WILEY, 2019, pp. S21–S21.
URI
https://scholars.duke.edu/individual/pub1415179
Source
wos
Published In
The Journal of Pathology
Volume
249
Published Date
Start Page
S21
End Page
S21

Abstract CT220: Expansion into multiple institutions for training in the use of the LUM Imaging System for intraoperative detection of residual cancer in the tumor bed of female subjects with breast cancer

Authors
Smith, K; Ferrer, JM; Smith, BL; Hwang, ES; Hunt, KK; Dodge, DG; Karp, SE; Valente, SA; Wapnir, IL; Clark, LP; Carr, DR; Beitsch, PD; Dyess, DL; Lesnikoski, B-A; Blumencranz, PW; Dekhne, NS; Gold, LP; Chagpar, A; Kacena, K; Gjylameti, L; Geissler, F
MLA Citation
Smith, Kate, et al. “Abstract CT220: Expansion into multiple institutions for training in the use of the LUM Imaging System for intraoperative detection of residual cancer in the tumor bed of female subjects with breast cancer.” Clinical Trials, American Association for Cancer Research, 2019. Crossref, doi:10.1158/1538-7445.am2019-ct220.
URI
https://scholars.duke.edu/individual/pub1416614
Source
crossref
Published In
Clinical Trials
Published Date
DOI
10.1158/1538-7445.am2019-ct220

Estimating the magnitude of clinical benefit of local therapy in patients with DCIS.

DCIS represents a heterogeneous disease with a wide range of outcomes according to biology. Without treatment, it is estimated that only 20-30% of DCIS will progress to invasive cancer. Long-term outcomes following treatment are at least as favorable as those for some other early stage cancer types such as prostate cancer, for which active surveillance is routinely offered as a standard of care option. However, active surveillance has not yet been tested in relation to DCIS. Worldwide, there are three international trials (LORIS, COMET, LORD) which are evaluating whether DCIS with favorable biologic features may be managed with close monitoring, with treatment only undertaken upon disease progression. These trials will determine whether there may be some women with low-risk DCIS who do not substantially benefit from treatment and who could thus be safely managed with close surveillance. If active monitoring for DCIS is deemed to be safe and feasible, additional work must be done to optimally implement this approach, involving effective communication between patients and their physicians about the risks and benefits of treatment versus surveillance. Importantly, these treatment decisions must take into account patient factors such as risk tolerance, age, and competing causes of mortality. Tailoring treatment to biology for early screen-detected cancers such as DCIS is an important goal of ongoing research. An improved understanding of the biology and clinical implications of this heterogeneous disease will improve the overall health and quality of life for hundreds of thousands of future women who will be diagnosed with DCIS.
Authors
Hwang, ES; Malek, V
MLA Citation
Hwang, E. Shelley, and Veronika Malek. “Estimating the magnitude of clinical benefit of local therapy in patients with DCIS..” Breast, vol. 48 Suppl 1, Nov. 2019, pp. S34–38. Pubmed, doi:10.1016/S0960-9776(19)31120-8.
URI
https://scholars.duke.edu/individual/pub1424796
PMID
31839157
Source
pubmed
Published In
Breast
Volume
48 Suppl 1
Published Date
Start Page
S34
End Page
S38
DOI
10.1016/S0960-9776(19)31120-8

Perturbed myoepithelial cell differentiation in BRCA mutation carriers and in ductal carcinoma in situ.

Myoepithelial cells play key roles in normal mammary gland development and in limiting pre-invasive to invasive breast tumor progression, yet their differentiation and perturbation in ductal carcinoma in situ (DCIS) are poorly understood. Here, we investigated myoepithelial cells in normal breast tissues of BRCA1 and BRCA2 germline mutation carriers and in non-carrier controls, and in sporadic DCIS. We found that in the normal breast of non-carriers, myoepithelial cells frequently co-express the p63 and TCF7 transcription factors and that p63 and TCF7 show overlapping chromatin peaks associated with differentiated myoepithelium-specific genes. In contrast, in normal breast tissues of BRCA1 mutation carriers the frequency of p63+TCF7+ myoepithelial cells is significantly decreased and p63 and TCF7 chromatin peaks do not overlap. These myoepithelial perturbations in normal breast tissues of BRCA1 germline mutation carriers may play a role in their higher risk of breast cancer. The fraction of p63+TCF7+ myoepithelial cells is also significantly decreased in DCIS, which may be associated with invasive progression.
Authors
Ding, L; Su, Y; Fassl, A; Hinohara, K; Qiu, X; Harper, NW; Huh, SJ; Bloushtain-Qimron, N; Jovanović, B; Ekram, M; Zi, X; Hines, WC; Alečković, M; Gil Del Alcazar, C; Caulfield, RJ; Bonal, DM; Nguyen, Q-D; Merino, VF; Choudhury, S; Ethington, G; Panos, L; Grant, M; Herlihy, W; Au, A; Rosson, GD; Argani, P; Richardson, AL; Dillon, D; Allred, DC; Babski, K; Kim, EMH; McDonnell, CH; Wagner, J; Rowberry, R; Bobolis, K; Kleer, CG; Hwang, ES; Blum, JL; Cristea, S; Sicinski, P; Fan, R; Long, HW; Sukumar, S; Park, SY; Garber, JE; Bissell, M; Yao, J; Polyak, K
MLA Citation
Ding, Lina, et al. “Perturbed myoepithelial cell differentiation in BRCA mutation carriers and in ductal carcinoma in situ..” Nat Commun, vol. 10, no. 1, Sept. 2019. Pubmed, doi:10.1038/s41467-019-12125-5.
URI
https://scholars.duke.edu/individual/pub1411882
PMID
31519911
Source
pubmed
Published In
Nature Communications
Volume
10
Published Date
Start Page
4182
DOI
10.1038/s41467-019-12125-5

Impact of Adjuvant Trastuzumab on Locoregional Failure Rates in the NCCTG N9831 (Alliance) Study

Authors
Thorpe, CS; Vargas, CE; Dueck, A; Tenner, KS; Perez, EA; Hwang, ES; Halyard, MY; Pisansky, TM; Davidson, N; Martino, S; Pockaj, BA
MLA Citation
Thorpe, C. S., et al. “Impact of Adjuvant Trastuzumab on Locoregional Failure Rates in the NCCTG N9831 (Alliance) Study.” International Journal of Radiation Oncology*Biology*Physics, vol. 105, no. 1, Elsevier BV, 2019, pp. S9–10. Crossref, doi:10.1016/j.ijrobp.2019.06.397.
URI
https://scholars.duke.edu/individual/pub1415145
Source
crossref
Published In
International Journal of Radiation Oncology, Biology, Physics
Volume
105
Published Date
Start Page
S9
End Page
S10
DOI
10.1016/j.ijrobp.2019.06.397