Nova Foster

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Scholarly Contributions

Journals/Publications

• Kishan, A. U., Gomez, C. L., Dawson, N. A., Dvorak, R., Foster, N. M., Hoyt, A., Hurvitz, S. A., Kusske, A., Silver, E. L., Tseng, C., & McCloskey, S. A. (2016). Increasing Appropriate BRCA1/2 Mutation Testing: The Role of Family History Documentation and Genetic Counseling in a Multidisciplinary Clinic. Annals of surgical oncology, 23(Suppl 5), 634-641.
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  Findings show that 5-10 % of women with a diagnosis of breast cancer (BCa) have actionable genetic mutations. The National Comprehensive Cancer Network guidelines for testing to detect BRCA1/2 mutations include personal history (PH) variables such as age of 45 years or younger and a family history (FH) variables. Rates of FH documentation and overall rates of appropriate referral for genetic testing are low, ranging from about 30 to 60 %. The authors hypothesized that an upfront FH documentation and inclusion of a genetics counselor in a multidisciplinary clinic (MDC) setting would increase rates of appropriate referral for genetic testing.
• Lightner, A. L., Shurell, E., Dawson, N., Omidvar, Y., & Foster, N. (2015). A single-center experience and review of the literature: 64 cases of phyllodes tumors to better understand risk factors and disease management. The American surgeon, 81(3), 309-15.
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  Phyllodes tumors of the breast are rare fibroepithelial tumors that are characterized as benign, borderline, or malignant based on cellular characteristics such as stromal overgrowth and number of mitoses. Currently, there is a lack of consensus on risk factors and management of patients with phyllodes tumors, which has led to variation in treatment patterns as well as patient outcomes across many institutions. This study seeks to understand the clinicopathologic features, risk factors for local and metastatic recurrence, and clinical outcomes of patients with phyllodes tumors to better define optimal treatment patterns.
• Gomez, C., Shah, C., McCloskey, S., Foster, N., & Vicini, F. (2014). The role of radiation therapy after nipple-sparing mastectomy. Annals of surgical oncology, 21(7), 2237-44.
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  The aim of this review was to examine the incidence of nipple-areola complex (NAC) involvement, the rates of NAC recurrence, and the data regarding the role of radiation therapy (RT) following nipple-sparing mastectomy (NSM).
• Cronin, J., Livhits, M., Mercado, C., Chen, F., Foster, N., Chandler, C., Gibbons, M., Ko, C. Y., & Chen, D. C. (2011). Quality improvement pilot program for vulnerable elderly surgical patients. The American surgeon, 77(10), 1305-8.
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  The elderly are a growing surgical population with more comorbidities and less physiological reserve compared with nonelderly patients. The objective of our study was to implement a quality improvement pilot program targeting the specific needs of the elderly. We prospectively enrolled consecutive patients aged 65 years or older undergoing inpatient general or vascular surgery operations. Patients completed a preoperative assessment including the Vulnerable Elder Survey (VES) to determine baseline functional status and incidence of polypharmacy (five or more medications). They were interviewed postdischarge Day 2 and Day 30 for changes in functional status. An intervention was implemented consisting of an elderly-specific postoperative order set and preoperative risk reports sent to the surgical team with instructions to order physical therapy consults and home health nursing on discharge for VES 3 or greater and geriatrics consults for patients with polypharmacy. The elderly-specific order set was used for 71 per cent of the postintervention group. There were no differences in the percentage of participants receiving physical therapy, geriatric, or home health nursing consults between the two groups. The postintervention group had significantly better functional status on postdischarge Day 30 (P < 0.01). Our preliminary data suggest that individualizing care for elderly patients is feasible and may improve postoperative outcomes.
• Foster, N. M., McGory, M. L., Zingmond, D. S., & Ko, C. Y. (2006). Small bowel obstruction: a population-based appraisal. Journal of the American College of Surgeons, 203(2), 170-6.
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  Small bowel obstruction (SBO) is a common reason for surgical consultation, but little is known about the natural history of SBO. We performed a population-based analysis to evaluate SBO frequency, type of operation, and longterm outcomes.

Presentations

• Foster, N. (2020, August). Quality and Safety Conference, Best Practices Case Studies, Volume 11. ACS 2020ACS.
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  Collaborative Model between Breast Surgery and Genetic Counseling Clinics to Reduce Wait Time for Pretest Genetic Counseling

Poster Presentations

• Chalasani, P., Roe, D., Jiralerspong, S., Ehsani Chimeh, S., Segar, J., Erdrich, J., Foster, N., Potluri, P., Farr, K., & Whittaker, M. (2022, December). Physician Practice Patterns of Breast Imaging After Treatment: Survey of Real-World Practice. San Antonio Breast Cancer Symposium. San Antonio Texas.
• Whittaker, M., Farr, K., Potluri, P., Foster, N., Erdrich, J., Segar, J., Ehsani Chimeh, S., Jiralerspong, S., Roe, D., & Chalasani, P. (2022, December). Physician Practice Patterns of Breast Imaging After Treatment: Survey of Real-World Practice. San Antonio Breast Cancer Symposium. San Antonio Texas.