Bio

Bio


Dr Jacqueline Tsai is a board certified general surgeon who completed a breast surgical oncology fellowship at Stanford and specializes in the diagnosis and treatment of all breast diseases and cancer. She is a breast surgical oncologist at Stanford Women's Cancer Center and has experience and interest in all types of breast surgery, including breast conservation, oncoplastic surgery and nipple sparing procedures to provide optimal cosmetic outcomes for all patients. Prior to joining the team at Stanford, she practiced in New York City at Weill Cornell Medical College and New York Presbyterian Hospital in Queens in the field of breast surgery.

Dr Tsai strives to provide compassionate, expert, evidence-based care for all patients. She works closely with plastic and reconstructive surgeons to help patients achieve both the optimal oncologic surgery as well as the desired cosmetic outcomes that patients desire. She is also involved in clinical trials that aim to improve diagnostic and therapeutic interventions for patients with breast cancer.

Clinical Focus


  • General Surgery
  • Breast Surgery

Academic Appointments


Professional Education


  • Fellowship: Stanford Hospital and Clinics - Dept of Surgery (2016) CA
  • Residency: Albert Einstein College of Medicine Montefiore Medical Center (2015) NY
  • Medical Education: Rutgers New Jersey Medical School Office of the Registrar (2008) NJ

Research & Scholarship

Current Research and Scholarly Interests


My research interests are focused on improving breast cancer surgeries. I am interested in novel techniques in surgery to improve cosmetic outcomes, minimize surgical re-excisions and possible augmented reality technologies to enhance surgery.

Publications

All Publications


  • The Impact of Device Innovation on Clinical Outcomes in Expander-based Breast Reconstruction PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN Momeni, A., Li, A. Y., Tsai, J., Wan, D., Karin, M. R., Wapnir, I. L. 2019; 7 (12)
  • Pretreatment Tattoo Marking of Suspicious Axillary Lymph Nodes: Reliability and Correlation with Sentinel Lymph Node ANNALS OF SURGICAL ONCOLOGY Patel, R., MacKerricher, W., Tsai, J., Choy, N., Lipson, J., Ikeda, D., Pal, S., De Martini, W., Allison, K. H., Wapnir, I. L. 2019; 26 (8): 2452–58
  • Pretreatment Tattoo Marking of Suspicious Axillary Lymph Nodes: Reliability and Correlation with Sentinel Lymph Node. Annals of surgical oncology Patel, R., MacKerricher, W., Tsai, J., Choy, N., Lipson, J., Ikeda, D., Pal, S., De Martini, W., Allison, K. H., Wapnir, I. L. 2019

    Abstract

    BACKGROUND: Tattooing is an alternative method for marking biopsied axillary lymph nodes (ALNs) before initiation of treatments for newly diagnosed breast cancer. Detection of black ink-stained nodes is performed under direct visualization at surgery and is combined with sentinel node (SLN) mapping procedures.METHODS: Women with newly diagnosed breast cancer who underwent fine or core-needle biopsy of suspicious ALNs were recruited. The nodal cortex and perinodal soft tissue was injected with 0.1-1.0ml of Spot (GI Supply) black ink under ultrasound guidance. Intraoperatively, black stained nodes were removed along with SLNs, noting concordance between the two.RESULTS: Sixty-six evaluable patients were enrolled (2013-2017). Nineteen received surgery first (Group 1) and 47 neoadjuvant therapy (NAT, Group 2). The average number of nodes tattooed was 1.16 for Group 1 and 1.04 for Group 2. The average interval from tattoo to surgery was 21days (range 1-62) for Group 1 and 148days (range 71-257) for Group 2. The tattooed node(s) were visually identified at surgery and corresponded to the sentinel lymph node(s) in 98.5% of cases (18/19 in Group 1 and 47/47 in Group 2). Of the 14 patients in Group 2 whose nodes remained positive following NAT, the tattooed node was the SLN associated with carcinoma.CONCLUSIONS: Tattooing is an alternative method for marking biopsied ALNs. Tattooed nodes coincided with SLNs in 98.5% of cases. This technique is advantageous, because it allows for fewer procedures and lower costs compared with other methods.

    View details for PubMedID 31087176

  • The Impact of Device Innovation on Clinical Outcomes in Expander-based Breast Reconstruction. Plastic and reconstructive surgery. Global open Momeni, A., Li, A. Y., Tsai, J., Wan, D., Karin, M. R., Wapnir, I. L. 2019; 7 (12): e2524

    Abstract

    Staged expander-based breast reconstruction represents the most common reconstructive modality in the United States. The introduction of a novel tissue expander with an integrated drain (Sientra AlloX2) holds promise to further improve clinical outcomes.Patients who underwent immediate expander-based pre-pectoral breast reconstruction were identified. Two cohorts were created, that is, patients who underwent placement of a conventional tissue expander [133MX (Allergan)] (Group 1) versus AlloX2 (Sientra) (Group 2). The study endpoint was successful completion of expansion with the objective being to investigate differences in outcome following expander placement.Fifty-eight patients underwent 99 breast reconstructions [Group 1: N = 24 (40 breasts) versus Group 2: N = 34 (59 breast)]. No differences were noted for age (P = 0.586), BMI (P = 0.109), history of radiation (P = 0.377), adjuvant radiotherapy (P = 1.00), and overall complication rate (P = 0.141). A significantly longer time to drain removal was noted in Group 1 (P < 0.001). All patients with postoperative infection in Group 1 required surgical treatment versus successful washout of the peri-prosthetic space via the AlloX2 drain port in 3 of 5 patients in Group 2 (P = 0.196). Furthermore, both cases of seroma in Group 1 required image-guided drainage versus in-office drainage via the AlloX2 drain port in 1 patient in Group 2 (P =0.333).The unique feature of the AlloX2 provides surgeons easy access to the peri-prosthetic space without altering any of the other characteristics of a tissue expander. This resulted in a reduced time to drain removal and facilitated management of postoperative seroma and infection.

    View details for DOI 10.1097/GOX.0000000000002524

    View details for PubMedID 32537287

    View details for PubMedCentralID PMC7288893

  • Pathological confirmation of pre-chemotherapy biopsied and tattooed axillary lymph nodes Patel, R., MacKerricher, W., Tsai, J., Wood, L., Allison, K., Wapnir, I. SPRINGER. 2018: 426–27
  • Lymph Node Ratio Analysis After Neoadjuvant Chemotherapy is Prognostic in Hormone Receptor-Positive and Triple-Negative Breast Cancer. Annals of surgical oncology Tsai, J., Bertoni, D., Hernandez-Boussard, T., Telli, M. L., Wapnir, I. L. 2016; 23 (10): 3310-3316

    Abstract

    Lymph node ratios (LNR), the proportion of positive lymph nodes over the number excised, both defined as ranges and single ratio values are prognostic of outcome. Little is known of the prognostic value of LNR after neoadjuvant chemotherapy (NAC) according to molecular subtype.From 2003 to 2014, patients who underwent definitive surgery after NAC were identified. LNR was calculated for node-positive patients who received axillary dissection or had at least 6 nodes removed. DFS was calculated using the Kaplan-Meier log rank test for yp N0-3 status, LNR categories (LNRC) ≤0.20 (low), 0.21-0.65 (intermediate), >0.65 (high), and single LNR values.Of 428 NAC recipients, 263 were node negative and 165 (38.6 %) node positive: ypN1 = 97 (58.8 %), ypN2 = 43 (26.1 %), and ypN3 = 25 (15.2 %). Among node-positive cancers, the median number of LN removed was 14 (range, 6-51) and the median LNR was 0.22 (range, 0.03-1.0). Nodal stage was inversely associated with 5-year DFS: 91.5 % (ypN0), 74.5 % (ypN1), 49.8 % (ypN2), and 50.7 % (ypN3) (p < 0.001). LNRC was similarly inversely associated with DFS: 69.1 % (low), 71.4 % (intermediate), 49.3 % (high) (p < 0.001). Significant associations between LNRC and DFS were demonstrated in hormone receptor (HR)-positive and triple negative breast cancer (TNBC) subtypes, p = 0.02 and p = 0.003. A single-value LNR ≤ 0.15 in node-positive, HR-positive (94.1 vs 67.7 %; p = 0.04) and TNBC (94.1 vs 47.8 %; p = 0.001) groups was also significant.Residual nodal disease after NAC, analyzed by LNRC or LNR = 0.15 cutoff value, is prognostic and can discriminate between favorable and unfavorable outcomes for HR-positive and TNBC cancers.

    View details for DOI 10.1245/s10434-016-5319-8

    View details for PubMedID 27401442

  • Disease-Free Survival Using Lymph Node Ratio Analysis After Neoadjuvant Chemotherapy Tsai, J., Bertoni, D., Tsai, C., Hernandez-Boussard, T., Wapnir, I. SPRINGER. 2016: 162–63
  • Internal hernia associated with perforated Meckel's diverticulum JOURNAL OF PEDIATRIC SURGERY CASE REPORTS Hui, V. W., Tsai, J., Gokarn, N., Statter, M. B. 2016; 4: 52–53

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