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Message: <blockquote data-quote="surg" data-source="post: 6555819" data-attributes="member: 8951">I would say that it opens different door and closes other ones.  As a group, I would say that surg onc fellowships do not provide as much breast as a dedicated breast fellowship (which is as it should be), however, there are exceptions.  Some breast fellowships are pretty light on surgical rotations, others are light on imaging, etc.  Similarly, some surg onc fellowships have a low volume of breast (either by time spent doing it or in dedicated rotations), others seem to have a high volume (Miami springs to mind, although that may have changed).  I would definitely agree though, that the average surg onc person does not get as much imaging experience or image guided biopsy experience in breast specific applications.  However, it can be done with surg onc training alone.  Breast ultrasound experience is becoming more common, and for all the time that you spend hitting liver lesions under ultrasound, once you learn how to find something on ultrasound in the breast (harder than it sounds), it isn't hard to learn to hit it with a needle.  Since the growth of breast fellowships, the number of surg onc trained people that want to do breast only has dropped dramatically through self-selection.  However, a number of surg onc people still make breast a significant part of their practice and probably about 15% of surg onc fellows make breast the dominant part (50% or greater) of their practice I'd say based on the last few years of graduates.As in breast fellowships, more surg onc graduates end up in the community than the powers that be really care to admit.  They will see whatever comes through by and large, and I suspect that those without breast surgeons in their group end up owning a lot of the breast cases as well.As to marketability, I think the surg onc side opens up the doors to groups that want someone that can do something more than breast and are looking for someone to take call.  There is some worry out there that breast-only fellows will be dissatisfied taking call, etc. (which many of them will be) and thus won't share equally in the work.  This can be solved with compensation differentials, but that can breed resentment as well.  On the other hand, a well trained breast fellow can really market the idea that breast is the ONLY thing that they do, and well-marketed, this can be a powerful draw.  Likewise, there is no worry that the breast fellow will show up at the group and suddenly decide that they don't want to focus on breast any more necessitating another recruitment if what they really needed was a breast person.  (don't laugh, it happens not that infrequently with surg onc people)</blockquote>

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