Photo of Michelle C. Specht,  MD

Michelle C. Specht, MD

Massachusetts General Hospital

Massachusetts General Hospital
Phone: (617) 726-0340


mspecht@partners.org

Michelle C. Specht, MD

Massachusetts General Hospital

EDUCATIONAL TITLES

  • Assistant Professor, Surgery, Harvard Medical School
  • Instructor in Surgery, Surgical Oncology, Massachusetts General Hospital

DF/HCC PROGRAM AFFILIATION

Research Abstract

Dr. Michelle Specht research interests are focused on the local treatment of breast cancer. Optimal treatment of early stage breast cancers includes wide excision of the tumor with negative margins. Achieving negative margins often requires multiple operations which are both financially and emotionally costly to the patient. Re-excision rates for early stage breast cancer after lumpectomy are reported to range from 30 - 50 %. Dr. Specht's research focuses on identifying pre-operative tools to better determine the extent of early stage breast cancers in order to decrease the number of operations needed to acheive negative margins.

Publications

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  • O'Toole JA, Ferguson CM, Swaroop MN, Horick N, Skolny MN, Brunelle CL, Miller CL, Jammallo LS, Specht MC, Taghian AG. The impact of breast cancer-related lymphedema on the ability to perform upper extremity activities of daily living. Breast Cancer Res Treat 2015; 150:381-8. PubMed
  • Chandra RA, Miller CL, Skolny MN, Warren LE, Horick N, Jammallo LS, Sadek BT, Shenouda MN, O'Toole J, Specht MC, Taghian AG. Radiation therapy risk factors for development of lymphedema in patients treated with regional lymph node irradiation for breast cancer. Int J Radiat Oncol Biol Phys 2015; 91:760-4. PubMed
  • Gfrerer L, Mattos D, Mastroianni M, Weng QY, Ricci JA, Heath MP, Lin A, Specht MC, Haynes AB, Austen WG, Liao EC. Assessment of patient factors, surgeons, and surgeon teams in immediate implant-based breast reconstruction outcomes. Plast Reconstr Surg 2015; 135:245e-52e. PubMed
  • Miller CL, Colwell AS, Horick N, Skolny MN, Jammallo LS, O╩╝Toole JA, Shenouda MN, Sadek BT, Swaroop MN, Ferguson CM, Smith BL, Specht MC, Taghian AG. Immediate Implant Reconstruction Is Associated With a Reduced Risk of Lymphedema Compared to Mastectomy Alone: A Prospective Cohort Study. Ann Surg 2015. PubMed
  • Moy B, Specht MC, Lanuti M, Rafferty EA, Lerwill MF. Case records of the Massachusetts General Hospital. Case 1-2015. A 66-year-old woman with metastatic breast cancer after endocrine therapy. N Engl J Med 2015; 372:162-70. PubMed
  • Tang R, Coopey SB, Specht MC, Lei L, Gadd MA, Hughes KS, Brachtel EF, Smith BL. Lumpectomy specimen margins are not reliable┬áin predicting residual disease in breast conserving surgery. Am J Surg 2015. PubMed
  • Miller CL, West JA, Bettini AC, Koerner FC, Gudewicz TM, Freer PE, Coopey SB, Gadd MA, Hughes KS, Smith BL, Rafferty E, Specht MC. Surgical excision of radial scars diagnosed by core biopsy may help predict future risk of breast cancer. Breast Cancer Res Treat 2014. PubMed
  • Warren LE, Miller CL, Horick N, Skolny MN, Jammallo LS, Sadek BT, Shenouda MN, O'Toole JA, MacDonald SM, Specht MC, Taghian AG. The impact of radiation therapy on the risk of lymphedema after treatment for breast cancer: a prospective cohort study. Int J Radiat Oncol Biol Phys 2014; 88:565-71. PubMed
  • Miller CL, Specht MC, Skolny MN, Horick N, Jammallo LS, O'Toole J, Shenouda MN, Sadek BT, Smith BL, Taghian AG. Risk of lymphedema after mastectomy: potential benefit of applying ACOSOG Z0011 protocol to mastectomy patients. Breast Cancer Res Treat 2014; 144:71-7. PubMed
  • Jammallo LS, Miller CL, Singer M, Horick NK, Skolny MN, Specht MC, O'Toole J, Taghian AG. Impact of body mass index and weight fluctuation on lymphedema risk in patients treated for breast cancer. Breast Cancer Res Treat 2013; 142:59-67. PubMed
  • O'Toole J, Jammallo LS, Skolny MN, Miller CL, Elliott K, Specht MC, Taghian AG. Lymphedema following treatment for breast cancer: a new approach to an old problem. Crit Rev Oncol Hematol 2013; 88:437-46. PubMed
  • Coopey SB, Tang R, Lei L, Freer PE, Kansal K, Colwell AS, Gadd MA, Specht MC, Austen WG, Smith BL. Increasing eligibility for nipple-sparing mastectomy. Ann Surg Oncol 2013; 20:3218-22. PubMed
  • Specht MC, Miller CL, Skolny MN, Jammallo LS, O'Toole J, Horick N, Isakoff SJ, Smith BL, Taghian AG. Residual lymph node disease after neoadjuvant chemotherapy predicts an increased risk of lymphedema in node-positive breast cancer patients. Ann Surg Oncol 2013; 20:2835-41. PubMed
  • Specht MC, Miller CL, Russell TA, Horick N, Skolny MN, O'Toole JA, Jammallo LS, Niemierko A, Sadek BT, Shenouda MN, Finkelstein DM, Smith BL, Taghian AG. Defining a threshold for intervention in breast cancer-related lymphedema: what level of arm volume increase predicts progression? Breast Cancer Res Treat 2013; 140:485-94. PubMed
  • O'Toole J, Miller CL, Specht MC, Skolny MN, Jammallo LS, Horick N, Elliott K, Niemierko A, Taghian AG. Cording following treatment for breast cancer. Breast Cancer Res Treat 2013; 140:105-11. PubMed
  • Macdonald SM, Patel SA, Hickey S, Specht M, Isakoff SJ, Gadd M, Smith BL, Yeap BY, Adams J, Delaney TF, Kooy H, Lu HM, Taghian AG. Proton Therapy for Breast Cancer After Mastectomy: Early Outcomes of a Prospective Clinical Trial. Int J Radiat Oncol Biol Phys 2013. PubMed
  • Carp SA, Sajjadi AY, Wanyo CM, Fang Q, Specht MC, Schapira L, Moy B, Bardia A, Boas DA, Isakoff SJ. Hemodynamic signature of breast cancer under fractional mammographic compression using a dynamic diffuse optical tomography system. Biomed Opt Express 2014; 4:2911-24. PubMed
  • Coopey SB, Mazzola E, Buckley JM, Sharko J, Belli AK, Kim EM, Polubriaginof F, Parmigiani G, Garber JE, Smith BL, Gadd MA, Specht MC, Guidi AJ, Roche CA, Hughes KS. The role of chemoprevention in modifying the risk of breast cancer in women with atypical breast lesions. Breast Cancer Res Treat 2012. PubMed
  • Pashtan IM, Recht A, Ancukiewicz M, Brachtel E, Abi-Raad RF, D'Alessandro HA, Levy A, Wo JY, Hirsch AE, Kachnic LA, Goldberg S, Specht M, Gadd M, Smith BL, Powell SN, Taghian AG. External beam accelerated partial-breast irradiation using 32 gy in 8 twice-daily fractions: 5-year results of a prospective study. Int J Radiat Oncol Biol Phys 2012; 84:e271-7. PubMed
  • Ancukiewicz M, Miller CL, Skolny MN, O'Toole J, Warren LE, Jammallo LS, Specht MC, Taghian AG. Erratum to: Comparison of relative versus absolute arm size change as criteria for quantifying breast cancer-related lymphedema: the flaws in current studies and need for universal methodology. Breast Cancer Res Treat 2012; 136:623. PubMed
  • Coopey SB, Specht MC, Warren L, Smith BL, Winograd JM, Fleischmann K. Use of Preoperative Paravertebral Block Decreases Length of Stay in Patients Undergoing Mastectomy Plus Immediate Reconstruction. Ann Surg Oncol 2012. PubMed
  • Greenup RA, Camp MS, Taghian AG, Buckley J, Coopey SB, Gadd M, Hughes K, Specht M, Smith BL. Cost comparison of radiation treatment options after lumpectomy for breast cancer. Ann Surg Oncol 2012; 19:3275-81. PubMed
  • Miller CL, Specht MC, Skolny MN, Jammallo LS, Horick N, O'Toole J, Coopey SB, Hughes K, Gadd M, Smith BL, Taghian AG. Sentinel lymph node biopsy at the time of mastectomy does not increase the risk of lymphedema: implications for prophylactic surgery. Breast Cancer Res Treat 2012; 135:781-9. PubMed
  • Camp MS, Greenup RA, Taghian A, Coopey SB, Specht M, Gadd M, Hughes K, Smith BL. Application of ACOSOG Z0011 Criteria Reduces Perioperative Costs. Ann Surg Oncol 2012. PubMed
  • Ancukiewicz M, Miller CL, Skolny MN, O'Toole J, Warren LE, Jammallo LS, Specht MC, Taghian AG. Comparison of relative versus absolute arm size change as criteria for quantifying breast cancer-related lymphedema: the flaws in current studies and need for universal methodology. Breast Cancer Res Treat 2012; 135:145-52. PubMed
  • Buckley JM, Coopey SB, Sharko J, Polubriaginof F, Drohan B, Belli AK, Kim EM, Garber JE, Smith BL, Gadd MA, Specht MC, Roche CA, Gudewicz TM, Hughes KS. The feasibility of using natural language processing to extract clinical information from breast pathology reports. J Pathol Inform 2012; 3:23. PubMed
  • Ancukiewicz M, Russell TA, Otoole J, Specht M, Singer M, Kelada A, Murphy CD, Pogachar J, Gioioso V, Patel M, Skolny M, Smith BL, Taghian AG. Standardized Method for Quantification of Developing Lymphedema in Patients Treated for Breast Cancer. Int J Radiat Oncol Biol Phys 2010. PubMed
  • Samphao S, Wheeler AJ, Rafferty E, Michaelson JS, Specht MC, Gadd MA, Hughes KS, Smith BL. Diagnosis of breast cancer in women age 40 and younger: delays in diagnosis result from underuse of genetic testing and breast imaging. Am J Surg 2009; 198:538-43. PubMed
  • Javid SH, Kirstein LJ, Rafferty E, Lipsitz S, Moore R, Rusby JE, Murphy CD, Hughes KS, Specht MC, Taghian AG, Smith BL. Outcome of multiple-wire localization for larger breast cancers: do multiple wires translate into additional imaging, biopsies, and recurrences? Am J Surg 2009; 198:368-72. PubMed
  • Murphy CD,Lee JM,Drohan B,Euhus DM,Kopans DB,Gadd MA,Rafferty EA,Specht MC,Smith BL,Hughes KS. The American Cancer Society guidelines for breast screening with magnetic resonance imaging: an argument for genetic testing. Cancer 2008; 113:3116-20. PubMed
  • Pandharipande PV,Harisinghani MG,Ozanne EM,Specht MC,Hur C,Lee JM,Gazelle GS. Staging MR lymphangiography of the axilla for early breast cancer: cost-effectiveness analysis. AJR Am J Roentgenol 2008; 191:1308-19. PubMed
  • Murphy CD,Jones JL,Javid SH,Michaelson JS,Nolan ME,Lipsitz SR,Specht MC,Lesnikoski BA,Hughes KS,Gadd MA,Smith BL. Do sentinel node micrometastases predict recurrence risk in ductal carcinoma in situ and ductal carcinoma in situ with microinvasion? Am J Surg 2008; 196:566-8. PubMed
  • Kirstein LJ,Rafferty E,Specht MC,Moore RH,Taghian AG,Hughes KS,Gadd MA,Smith BL. Outcomes of multiple wire localization for larger breast cancers: when can mastectomy be avoided? J Am Coll Surg 2008; 207:342-6. PubMed
  • Katz A, Smith BL, Golshan M, Niemierko A, Kobayashi W, Raad RA, Kelada A, Rizk L, Wong JS, Bellon JR, Gadd M, Specht M, Taghian AG. Nomogram for the prediction of having four or more involved nodes for sentinel lymph node-positive breast cancer. J Clin Oncol 2008; 26:2093-8. PubMed
  • Miller JC, Rafferty EA, Specht MC, Thrall JH, Lee SI. When is breast magnetic resonance imaging recommended for cancer detection? J Am Coll Radiol 2008; 5:224-6. PubMed
  • Dominguez FJ, Golshan M, Black DM, Hughes KS, Gadd MA, Christian R, Lesnikoski BA, Specht M, Michaelson J, Smith BL. Sentinel node biopsy is important in mastectomy for ductal carcinoma in situ. Ann Surg Oncol 2007; 15:268-73. PubMed
  • Black D, Specht M, Lee JM, Dominguez F, Gadd M, Hughes K, Rafferty E, Smith B. Detecting occult malignancy in prophylactic mastectomy: preoperative MRI versus sentinel lymph node biopsy. Ann Surg Oncol 2007; 14:2477-84. PubMed
  • Dominguez FJ, Lawrence C, Halpern EF, Drohan B, Grinstein G, Black DM, Smith BL, Gadd MA, Specht M, Kopans DB, Moore RH, Hughes SS, Roche CA, Hughes KS. Accuracy of Self-Reported Personal History of Cancer in an Outpatient Breast Center. J Genet Couns 2007; 16:341-5. PubMed
  • Zabicki K, Colbert JA, Dominguez FJ, Gadd MA, Hughes KS, Jones JL, Specht MC, Michaelson JS, Smith BL. Breast Cancer Diagnosis in Women PubMed
  • Specht MC, Kattan MW, Gonen M, Fey J, Van Zee KJ. Predicting nonsentinel node status after positive sentinel lymph biopsy for breast cancer: clinicians versus nomogram. Ann Surg Oncol 2005; 12:654-9. PubMed
  • Specht MC, Fey JV, Borgen PI, Cody HS. Is the clinically positive axilla in breast cancer really a contraindication to sentinel lymph node biopsy? J Am Coll Surg 2005; 200:10-4. PubMed
  • Specht MC, Borgen PI, Fey J, Zhang Z, Sclafani L. Personal health behaviors in women who have undergone risk-reducing mastectomy. Am J Surg 2004; 188:448-9. PubMed
  • Teng L, Specht MC, Barden CB, Fahey TJ. Antisense hTERT inhibits thyroid cancer cell growth. J Clin Endocrinol Metab 2003; 88:1362-6. PubMed
  • Specht MC, Tucker ON, Hocever M, Gonzalez D, Teng L, Fahey TJ. Cyclooxygenase-2 expression in thyroid nodules. J Clin Endocrinol Metab 2002; 87:358-63. PubMed
  • Tang R, Coopey SB, Buckley JM, Aftreth OP, Fernandez LJ, Brachtel EF, Michaelson JS, Gadd MA, Specht MC, Koerner FC, Smith BL. A pilot study evaluating shaved cavity margins with micro-computed tomography: a novel method for predicting lumpectomy margin status intraoperatively. Breast J 2013; 19:485-9. PubMed
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