The Breast Surgical Oncology Fellowship Returns to Saint John’s in Full Swing

Dr. Nicketti Handy realized she loved taking care of cancer patients while in her residency. Inspired by how breast cancer treatment has evolved by incorporating oncoplastic surgery, she found her purpose in improving women’s lives. As Dr. Handy describes in her interview, planning and decision-making are a critical part of this modern, integrated method, affording an “artistic component” to the care approach.

It was during her residency at Virginia Mason Medical Center that Dr. Handy met Dr. Janie Grumley, who is now the director of the breast program at Margie Petersen Breast Center. Dr. Grumley indicated that a breast fellowship was in the works and would soon be open for applicants. With an understanding of the caliber and structured nature of Dr. Grumley as a breast surgical oncologist, Dr. Handy knew the program would be “high-performing” and a “really good fit.” She was ready to apply.

It’s been everything I could ask for and more.

– Dr. Nicketti Handy

The breast fellowship at Saint John’s is a one-year fellowship. Dr. Crystal Fancher, a breast surgical oncologist who works with Dr. Grumley at the Margie Petersen Breast Center, is also credited as having particular skills in oncoplastics. Oncoloplastic breast surgery combines cancer treatment and breast reconstruction within the same operation, potentially reducing two surgeries into one. This provides the patient many benefits including a reduction in total recovery time and improved outcomes by having greater flexibility in tissue removal around the cancer site. With oncoplastic surgery, there are many surgical techniques employed to contour the reconstruction, including bilateral breast reduction, which helps to maintain breast symmetry after tissue removal.

It’s a really collaborative atmosphere, so even though I’m the only breast fellow, I certainly don’t feel like I’m the only fellow here at Saint John’s.

– Dr. Nicketti Handy

Working closely with the other fellows at Saint John’s

The institute also boasts the Donald L. Morton, MD Complex General Surgical Oncology Fellowship, the Neurosurgical Oncology Fellowship, the Urologic Oncology Fellowship, and the Translational Molecular Medicine Fellowship. They focus on a legacy of research excellence and intense collaboration, ensuring that fellows learn from their mentors as well as each other. Each of these programs may have several fellows enrolled in one- or two-year programs.

Dr. Nicketti Handy, Surgical Breast Fellow, Saint John's Cancer Institute
Dr. Nicketti Handy, Surgical Breast Fellow, Saint John’s Cancer Institute
The fellows at Saint John’s Cancer Institure work with and engage each other, supporting a nurturing learning environmnet. “Every Friday morning we have didactics that are set aside where we go through interesting cases we talk about interesting academic learning points. We all touch and share resources on various research projects that we are working on together so it’s a really collaborative atmosphere, explains Dr. Handy.” “There’s a really satisfying and in-depth Community.”


Dr. Nicketti Handy Shares Her Breast Fellowship Experience

Dr. Nicketti Handy shares her fellowship experience at Saint John’s Cancer Institute in Santa Monica.

What’s covered in Dr. Handy’s video interview?

    Saint John's Health Center in Santa Monica, California
    Saint John’s Health Center in Santa Monica, California
  • Meet Dr. Nicketti Handy
  • Schedules and Rotations
  • Multi-disciplinary Clinic
  • Clinical research at Saint John’s
  • Approach and role of the breast fellow in tumor boards
  • What makes Saint John’s unique?
  • Being ready to work on your own
  • How did you learn about this breast fellowship?
  • What’s next for Dr. Handy in the breast training program?

Tumor Boards: The Role of the Breast Surgical Oncology Fellow

The breast fellow is in charge of leading the tumor board. They must collect all the information about the patients who will be discussed, including gathering relevant slides from the radiologists. The pathologists also participate and work closely with the fellows, providing context to findings and in-depth knowledge. Each case is discussed in detail focusing on the diagnosis and whether neo-adjuvant therapy is advised. This allows the breast fellow to discuss the full scope of options with their patient with a tailored treatment approach widely shared by experts.

I know our pathologists!

– Dr. Nicketti Handy

“It’s a special place where you know each other,” says Dr. Handy. “I’m able to go just down the hall and tap their shoulder and say, hey do you mind taking a look at this patient?” This collegial atmosphere helps to foster the skills and education of each fellow. “We just work really well with being able to accommodate requests from one another and having a really collaborative, close-knit environment. And so again, it ends up being good for patient care but also good from a learner’s perspective,” says Handy.

Santa Monica, CA
Santa Monica, CA

Being in Santa Monica, California

Dr. Handy explains how fun it is to live in Los Angeles, specifically Santa Monica. “It’s beautiful and sunny most days, and I love roller skating, so I have joined a roller-skating gang, The LA Skate Honeys.” Santa Monica boasts 281 sunny days per year with an average temperature between 65 and 70 degrees, making this coastal upbeat city a highly desirable place to live and work.


“I’ve actually had a lot of visitors while I’ve been here and that’s been a really fun adventure as well,” explains Dr. Handy, thinking about her family. Dr. Handy will be graduating from the Breast Surgical Oncology Fellowship in July 2024.

If you are interested in the Surgical Breast Fellowship at Saint John’s, click here to learn more about the program, including an overview with Dr. Janie Grumley and a virtual tour, narrated by Dr. Crystal Fancher.

Janie Grumley, MD, FACS

Crystal Fancher, MD, FACS

The Margie Petersen Breast Center, a Center of Excellence

About the Authors

David Austin,