Presenter Details

M.B.A.'24, P'23, Mary and Deryl Hart Distinguished Professor of Surgery, School of Medicine, Vice-Chair of Research, Department of Surgery

Shelley Hwang, MD, MPH, is one of the world’s foremost experts in early-stage breast cancers. As a surgeon at the Duke Cancer Institute, Dr. Hwang is trained to perform the most delicate yet common procedure for treating breast cancer: removing tumors, and often much of the breast itself, to give women the best chance of avoiding recurrence and having the cancer spread to other parts of the body. But with better screening and detection of the disease, she became uncomfortable with the drastic approach for some of her patients. The earliest stage of breast cancer, known as ductal carcinoma in situ (DCIS), often does not spread beyond the breast or cause serious disease. About a decade ago, she proposed a radical idea: asking these women whether they would rather avoid surgery and instead monitor their cancer very closely with more regular mammograms. They could always turn to surgery if their disease worsened. She created a landmark study to test the idea by randomly assigning women to surgery or active surveillance. In 2024, the first results of the study supported her hunch. Women in both groups showed about the same amount of breast cancer, which suggests that avoiding surgery didn’t lead to a significantly higher risk of the disease. Hwang plans to follow the women for 10 years, but is encouraged by what she’s seen so far. “For the lowest risk DCIS, like the ones in this study, surgery may not ultimately be needed,” she says. Dr. Hwang serves as the Mary and Deryl Hart Distinguished Professor of Surgery in the School of Medicine and Vice-Chair of Research in the Department of Surgery. She was named one of TIME’s 100 most influential people in both 2025 and 2016 as a pioneer in her field. Her 2016 Time magazine report was written by musician and breast cancer survivor Melissa Etheridge.