Reshaping Breast Cancer Surgery and Minimizing Radical Treatment Approaches

Tran Ho, DO, FSSO, FACS, discussed how she found her passion in breast surgical oncology and how her mentors helped her achieve success.

Finding something to be passionate about in life can be rare, and finding it through your career can be even rarer. For Tran Ho, DO, FSSO, FACS, she knew as soon as she completed her surgery rotation that she had found her career.

Ho, a breast surgical oncologist, spoke with CancerNetwork® about her career and her most recent position at El Camino Health.¹ Here, she treats patients with breast cancer and benign breast disease while working to build up the multidisciplinary breast cancer clinic and expand programs for high-risk, survivorship, and functional recovery.

“I was always drawn to the field of oncology. In medical school, I did my surgery rotation, though, and I couldn't let surgery go. I thought it was just a fluke and tried to convince myself otherwise, but I just loved it. The technical precision, the anatomy, and the immediate impact that I could have on a patient’s journey were all rewarding to me. It all worked out well because I had a mentor who introduced me to the field of breast surgical oncology, and I am now able to both care for cancer patients and perform surgeries,” Ho said.

The Importance of a Multidisciplinary Breast Clinic

Aside from the surgery aspect, Ho was drawn to breast cancer because of the direct impact she has on patients’ lives as well as the ongoing research in the field. Through constant advancements in treatment and surgery, patient quality of life is beginning to improve as well.

After completing a fellowship at Emory University School of Medicine, Ho joined practices in Florida and California’s Central Valley. She transitioned to El Camino Health to be closer to her family. She is currently the Breast Cancer Program Co-Director and the Multidisciplinary Conference Chairperson.

El Camino Health is working to build up its breast cancer program and multidisciplinary clinic. Through this initiative, they hope to increase timely access to care and allow for patients in the community to have personalized treatment plans. Ho also noted that the use of multidisciplinary care has allowed for improved patient outcomes.

“We perform comprehensive case reviews on our patients with cancer. We have collaborative decision-making among all the specialists, including surgeons, medical oncologists, radiation oncologists, pathologists, radiologists, and all other disciplines. It’s a meeting of the minds which results in evidence-based and cohesive care for patients,” Ho said.

A Background in Breast Cancer

Ho served as a principal investigator at a cancer center in the Central Valley, participating in the PREDICT Registry study (NCT03448926), which assessed the DCISionRT® test, a tool for the prediction of radiation therapy benefits in patients with ductal carcinoma in situ. The goal of the trial was to determine a recommendation of radiation therapy pre- and post-DCISionRT testing. The primary end point was the percentage of patients in whom using DCISionRT led to a change in radiation therapy recommendation.

Updated results from 2024 showed that the recommendation of radiation therapy was changed in 38% of patients, which showed a 20% decrease in the overall recommendation of radiation (P <.001).² For patients who were initially not recommended radiation therapy, 31% were recommended treatment post-DCISionRT testing.

“Being a part of this research is something I’m proud of because it contributes to the goal of personalized medicine. It enhances our patient outcomes, and it provides us with a tool to not under- or over-treat patients. It empowers patients and clinicians to have more precise information and make informed decisions,” Ho noted. “Overall, it’s a step towards improving the management of cancer through innovative diagnostic tools and techniques.”

Looking at the breast cancer field, Ho highlighted that it is constantly evolving. The goal is to do less but to achieve the same or better outcomes with fewer adverse effects.

In the past, breast cancer surgery consisted of removing the breast and muscle, which Ho noted as radical. Now, for patients who qualify, a lumpectomy can be performed to preserve the contour of the breast. For mastectomies, even the skin, nipple, and areola can be spared in some patients to allow for good cosmesis. Sentinel lymph node surgery has also drastically changed breast cancer surgery, as it leads to less lymphedema.

“The evolution of the breast field is remarkable because we’ve had radical treatments reduced over time, and we’ve been able to maintain great outcomes for patients. That’s all proven through numerous trials and research on different patient populations,” Ho said.

Defining Herself in the Surgery World

As with anything, breaking into a new field can be difficult. Ho noted that while most surgeons feel equipped to handle the technical or knowledge-based responsibilities, it may take time to develop skills outside of the operating room. Areas like navigating the complex health care system, handling nuances in patient care, and navigating work-life balance are learned on the job, not in the classroom. For Ho, all these aspects are important to becoming a well-rounded clinician.

Ho’s mentors helped to give her guidance and support. She highlighted that there are incredible leaders in her field, and having their support and guidance allowed her to be in the position she is today. While her mentors may not have had the answers to every situation, she believed there was value in learning from their successes and setbacks.

“We can’t control everything, and there will always be setbacks. In general, that’s a part of growth in our career and life,” Ho said regarding the most helpful advice she has held on to along the way.

References

1. El Camino Health expands oncology team with highly skilled specialists. News release. El Camino Health. July 24, 2025. Accessed July 24, 2025. https://tinyurl.com/45tswaeb
2. Shah C, Whitworth P, Vicini FA, et al. The clinical utility of a 7-gene biosignature on radiation therapy decision making in patients with ductal carcinoma in situ following breast-conserving surgery: an updated analysis of the DCISionRT^® PREDICT study. Ann Surg Oncol. 2024;31(9):5919-5928. doi:10.1245/s10434-024-15566-5