About

Whitney O'Neill Lane is an Assistant Professor of Surgery at Duke University and a member of the Duke Cancer Institute. He is involved in the Integrated Plastic and Reconstructive Surgery Residency Program and participates in the Duke Surgical Technique and Review (STAR) Course. His professional role is based at B203 LSRC in Durham, North Carolina, with a mailing address at Box 90999, Durham, NC 27708. His work focuses on plastic, maxillofacial, and oral surgery, contributing to the education and training of residents and fellows in these fields.

Research topics

• Internal medicine
• Medicine
• Family medicine
• Business
• Surgery
• Nursing
• Pathology
• Psychology
• Intensive care medicine
• Finance
• Economic growth
• Oncology

Selected publications

• The Impact of Neoadjuvant Chemotherapy on Implant-Based Breast Reconstruction Outcomes

  Plastic & Reconstructive Surgery · 2025-08-26 · 1 citations

  article

  BACKGROUND: Neoadjuvant chemotherapy (NACT) is a critical component of breast cancer treatment, yet its impact on tissue expander (TE)-based breast reconstruction remains unclear. The purpose of this study was to examine the impact of NACT on complication rates after immediate TE-based breast reconstruction and on the commencement of adjuvant radiotherapy. METHODS: Female patients who underwent immediate TE-based breast reconstruction between 2017 and 2022 were included. Inclusion criteria consisted of patients who completed NACT within 2 months of mastectomy and those who did not receive chemotherapy. Patients who underwent bilateral prophylactic mastectomy, delayed reconstruction, adjuvant chemotherapy, and neoadjuvant radiation therapy were excluded. RESULTS: A total of 2013 patients were included, of whom 1202 (59.7%) received NACT, and 811 (40.3%) did not receive chemotherapy. The rate of TE loss was significantly higher in the NACT cohort than in the control cohort (9.8% versus 3.9%; P < 0.001). Multivariable regression models showed that NACT significantly increases the rate of TE loss (OR, 2.39; 95% CI, 1.47 to 3.93; P < 0.001) but no other complications, including cellulitis. NACT did not delay the commencement to radiation therapy. However, patients who developed cellulitis started radiation therapy on average 17 days later than those who did not (95% CI, 3.5 to 31; P = 0.014). CONCLUSIONS: NACT is a significant predictor of TE loss but does not prolong the commencement to radiotherapy. The increased rate of TE loss among the NACT group may reflect a higher rate of adjuvant radiation treatment and the combination of the deleterious effects of NACT and radiation therapy on wound healing.

  PublisherDOI

• Understanding Breast Cancer Images in Art History as a Form of Health Communication

  Journal of Health Communication · 2024-05-02 · 1 citations

  article

  Can art and visual images meant for public consumption (museums, galleries, social media platforms) serve as a critical form of health communication for breast cancer patients? For their clinicians? For the population at large? Art history research methods are applied to a range of breast cancer images in western art in order to understand what the images communicate to us about patient experience, agency, and inequity in health care at the time of their construction. The following is a selective look at western art as it reflects and informs our understanding of breast cancer over time.

  PublisherDOI

• Double Medial Circumflex Femoral Artery Perforator Flaps for Unilateral Breast Reconstruction—A Case Report

  Microsurgery · 2024-11-01

  article

  Thigh-based free flaps are a common second-line options in autologous breast reconstruction when the abdominal donor site is unavailable. While the profunda artery perforator (PAP) flap and gracilis-based flaps are most commonly utilized in this scenario, certain anatomic variations may favor alternative flap selection. One such option is the medial circumflex femoral artery perforator flap (MCFLAP). This report describes a case of a 60-year-old patient with a history of abdominoplasty and left breast cancer who underwent skin sparing mastectomy, adjuvant radiation, and ultimately, unilateral autologous breast reconstruction using stacked MCFLAPs. While PAP flaps were initially considered, preoperative CT imaging revealed large septocutaneous perforators originating from the MCFA system, bilaterally. The flaps were designed and harvested on these perforators and weighed 335 g on the right and 355 g on the left. The internal mammary system was accessed at the level of the third rib, and the anterograde and retrograde artery and vein were used as recipient vessels. The patient did not experience any complications postoperatively. A revisionary and symmetrizing procedure was performed several months later, and at 18 months, the patient had completely healed and reported satisfaction with the reconstruction. In addition to a detailed case description, the purpose of this report is to provide a review of the available literature on the MCFLAP including the anatomy, indications, and potential benefits and downfalls of this rare perforator flap. While the PAP flap is our preferred second-line option for autologous breast reconstruction, it is important to be aware that in some instances the more suitable perforators may be arising from the MCFA system. In such cases, the MCFLAP should be considered.

  PublisherDOI

• 16. Knowledge is Power – Designing a Pilot Plastic Surgery Residency “Curated Wiki” to Improve Efficiency and Spread Institutional Knowledge

  Plastic & Reconstructive Surgery Global Open · 2023-02-01

  articleOpen access

  Background: While the literature has examined plastic surgery formal curricula, institutional knowledge and the informal curriculum are less explored. The “curated wiki” concept, an end user-driven comprehensive resource for institutional knowledge and informal expectations, is heavily used in industry and scientific fields, and is proven to improve employee efficiency and reduce person-hours per unit production. However, this concept has only recently been adopted by residency programs. Studies from internal medicine, pathology, and radiology residencies show that curated wikis significantly improve education, efficiency, overall experience, and exam scores. We present a framework for program-specific curated wikis, based on 3 current practices. Methods: Plastic surgery residents and academic faculty, who previously expressed interest in curated resources for plastic surgery education, were informally interviewed. Questions targeted plastic surgery-specific resources used to curate and disseminate medical and institutional knowledge, and informal curriculum components. Follow-up questions were asked to explore participant needs/suggestions, to determine specific components a curated wiki should contain, and to develop a formal questionnaire for future research. Results: Thirteen residents and faculty at 8 programs participated. No programs had a comprehensive curated resource. Two programs had limited resources produced by a single attending, and 1 program had a comprehensive guide to surgical cases, maintained by one resident without institutional support. Five programs had no curated plastic surgery resource. Programs sometimes offered a physical “general intern’s guide” produced by general surgery departments. Residents and faculty both believed curated wikis would speed the learning curve for new residents, could streamline “instrument card” issues, and would reduce burnout. Residents cited reduction in personal stress and a smoother return from off-service rotations as benefits, while faculty cited reduction in resident errors and clearer expectations of residents/more explicit resident duties as benefits. Participant recommendations for content are presented. Conclusion: The curated wiki concept has significant, proven value in industry, scientific fields, and other residency specialties. Given this value, implementing a curated wiki in a plastic surgery residency program has high potential value. We present content guidelines for an internal curated wiki, which can easily be adopted by residency programs.

  PublisherDOI

• 24. The Duke Microsurgery Training Model: Curriculum Creation and Implementation

  Plastic & Reconstructive Surgery Global Open · 2023-02-01

  articleOpen access1st authorCorresponding

  Background: Given the increased emphasis on patient safety within healthcare systems, the ACGME now supports the use of competency-based education models. In surgery, the Fundamentals of Laparoscopic Surgery and Endoscopic Surgery were created to ensure a basic level of competency among graduating general surgery residents. In plastic surgery, despite the highly technical nature of the field, there are no comparable national programs. Regarding microsurgery, currently only 16% of programs require a skills assessment prior to participation in microsurgery in the operating room. Furthermore, 77% of residents think that a comprehensive, multi-year training curriculum would be beneficial. Therefore, our goal was to create a comprehensive, multi-year curriculum for Duke Plastic Surgery residents to develop microsurgery skills. Methods: The Duke Microsurgery Training Model was created by evaluating currently published curricula for microsurgery training including currently available skills simulations and assessment rubrics. They were then adapted into a proposed multi-year microsurgery curriculum for a 6-year integrated residency program to support the development of microsurgery skills. Results: We developed a 6-year microsurgery curriculum that will be implemented over the course of this year. Based on the curriculum, each class has one dedicated teaching session in the microsurgery lab to work on a pre-defined set of level appropriate skills. Additionally, the PGY 1/2 classes will have a dedicated introduction to microsurgery including the standard instruments and use and the microscope use. The curriculum will be evaluated using standardized survey data and will be iteratively improved based on resident feedback. Further, each resident will be video recorded performing an end-to-end anastomosis at the end of each year. These will be reviewed and graded in a blinded manner using the Stanford Microsurgery and Resident Training Scale (SMaRT). The grades will be released to the residents yearly as part of their comprehensive feedback. Conclusion: Creation and implementation of the Duke Microsurgery Training Model will allow Duke to create a standardized and competency-based training model for the highly technical skill of microsurgical anastomosis. Using this model, we hope to have the junior residents become proficient in microsurgical skills before performing these skills intraoperatively.

  PublisherDOI

• 5. The Resident Review: A Plastic Surgery Educational Podcast

  Plastic & Reconstructive Surgery Global Open · 2022-05-01

  articleOpen access

  Background: There is currently a paucity of online educational material for Plastic Surgery trainees. While other specialties have developed podcasts and websites to aid in test preparation, a similar media platform did not exist within Plastic Surgery. Thus, our aim was to provide a novel avenue for high-quality and accessible Plastic Surgery education through creation of a podcast. Methods: The Resident Review, the first Plastic Surgery educational podcast, was launched in 2019. Each podcast included an expert in the field of discussion, except for our “Quick Hits” series, which served as a review for our in-service examination. Other series included “Microsurgery Masters,” featuring leaders in microsurgery, “Flap Cast,” which helped residents review flap anatomy and prepare for perforator dissections, and “Back to Basics,” which aimed to prepare medical students for Plastic Surgery rotations. Results: Our team has created 83 episodes including 46 “Quick Hits,” 2 “Microsurgery Masters,” 6 “Flap Cast,” 6 “Back to Basics,” and 23 traditional episodes. To date, 21% of the episodes pertain to hand surgery, 18% discuss microsurgery topics, 13% cover aesthetic surgery, and the remainder discuss general reconstruction. The total listens since conception is over 43,000 with 12% international listens and a 700% growth in 2021. We have included guest hosts from the Buncke Clinic, M.D. Anderson Cancer Center, Northwestern University, Emory University, Duke University, and Asan Medical Center in South Korea, among others. In addition, we created the first URM (under-represented minority) scholarship to support medical student sub-internships in Plastic Surgery. Over 10 other institutions have followed suit, with the first class rotating this year. Conclusion: The Resident Review was created to provide high-quality and equitable educational material for exam preparation, case review, and general Plastic Surgery education. Through institutional partnerships, scientific conference participation, and industry support, we have become a primary source for high-yield and purposeful Plastic Surgery content. Future goals include an increased international reach, production of additional video content, patient education, and creation of a research network to assist with multi-institutional participation.

  PublisherDOI

• Guideline Awareness Disparities in Plastic Surgery: A Survey of American Society of Plastic Surgeons

  Plastic & Reconstructive Surgery Global Open · 2022-08-01 · 1 citations

  articleOpen access

  Background: The American Society of Plastic Surgeons (ASPS) clinical practice guidelines were constructed to help direct evidence-based surgical management in plastic surgery. Societal member awareness of the recommendations for breast reconstruction has yet to be studied among ASPS members. Methods: Univariate and multivariate analyses were performed using electronic survey data from 243 ASPS members. Characteristics, including respondent demographics, practice distribution, and geographic locations, were correlated to the awareness of autologous and expander/implant-based reconstruction guidelines. Results: Of the respondents, 52% and 35.7% reported awareness for autologous breast reconstruction and expander/implant-based reconstruction guidelines, respectively. Surgeons who performed more general and autologous breast reconstruction were more likely to be aware of autologous breast reconstruction and expander/implant-based guidelines ( P = 0.0034 and 0.032). Autologous breast reconstruction guideline awareness was geographically disparate ( P = 0.031), with greater awareness in the Northeast (OR, 4.5; 95% CI, 1.63–12.53; P = 0.01) and Southwest (OR, 3.91; 95% CI, 1.18–13.83; P = 0.01). Respondents with larger practice percentages of breast reconstruction and those with higher annual academic meeting attendance reported greater awareness of expander/implant-based guidelines ( P = 0.044 and 0.040). Meeting attendance (OR, 2.14; 95% CI, 1.15–8.91; P = 0.022) and practice-based (OR, 3.14; 95% CI, 1.52–8.91; P = 0.027) awareness disparities were also appreciated on multivariate analysis. Conclusions: Guideline awareness in plastic surgery varies by practice composition and geography. These findings can be used to help inform more targeted educational and implementation strategies in breast reconstruction. Clinical Question/Level of Evidence: Quality Improvement/Level IV

  PublisherDOI

• Extent of tumor fibrosis/hyalinization and infarction following neoadjuvant radiation therapy is associated with improved survival in patients with soft‐tissue sarcoma

  Cancer Medicine · 2021 · 11 citations

  • Medicine
  • Internal medicine
  • Oncology

  INTRODUCTION: Current standard of care for most intermediate and high-grade soft-tissue sarcomas (STS) includes limb-preserving surgical resection with either neoadjuvant radiation therapy (NRT) or adjuvant radiation therapy. To date, there have been a few studies that attempt to correlate histopathologic response to NRT with oncologic outcomes in patients with STS. METHODS: Using our institutional database, we identified 58 patients who received NRT followed by surgical resection for primary intermediate or high-grade STS and 34 patients who received surgical resection without NRT but did receive adjuvant radiation therapy or did not receive any radiation therapy. We analyzed four histologic parameters of response to therapy: residual viable tumor, fibrosis/hyalinization, necrosis, and infarction (each ratiometrically determined). Data were stratified into two binary groups. Unadjusted, 5- and 10-year overall survival, and relapsed-free survival (RFS) were calculated using the Kaplan-Meier method. RESULTS: Analysis of pathologic characteristics showed that patients treated with NRT demonstrate significantly higher tumor infarction, higher tumor fibrosis/hyalinization, and a lower percent viable tumor compared with patients not treated with NRT (p < 0.0001). Based on Kaplan-Meier curve analysis and multivariate cox proportional hazard model for OS and RFS, patients treated with NRT and showing >12.5% tumor fibrosis/hyalinization have significantly higher overall survival and recurrence-free survival at 5 and 10 years. DISCUSSION AND CONCLUSION: We have identified three histopathologic characteristics-fibrosis, hyalinization, and infarction-that may serve as predictive biomarkers of response to NRT for STS patients. Future prospective studies will be needed to confirm this association.

  PublisherDOI

• Patient Perspectives on the Financial Costs and Burdens of Breast Cancer Surgery

  JCO Oncology Practice · 2021 · 25 citations

  • Medicine
  • Family medicine
  • Finance

  PURPOSE: Although financial toxicity is a well-documented aspect of cancer care, little is known about how patients narratively characterize financial experiences related to breast cancer treatment. We sought to examine these patient experiences through mixed methods analysis. METHODS: Women (≥ 18 years old) with a history of breast cancer were recruited from the Love Research Army and Sisters Network to complete an 88-item electronic survey including an open-ended response. Quantitative data were used to sort and stratify responses to the open-ended question, which comprised the qualitative data evaluated here. Descriptive statistics and qualitative content analysis were used to evaluate the financial costs and other burdens resulting from breast cancer surgery. RESULTS: for many participants. Discrepancies existed between the degree of financial burden reported on multiple-choice questions and participants' corresponding open-ended descriptions of financial burden. Participants described a lack of communication surrounding costs with their providers and difficulty negotiating payments with insurance. CONCLUSION: Breast cancer care can result in ongoing financial burden years after diagnosis among all patients, even those with adequate insurance patient populations.

  PublisherOA PDFDOI

• Where advocacy meets patient-centered care—cost considerations in breast reconstruction decision-making

  Gland Surgery · 2021 · 4 citations

  1st authorCorresponding
  • Medicine
  • Family medicine
  • Intensive care medicine

  Cancer care in the United States is unquestionably expensive. In 2017, annual costs related to cancer-related treatment reached $180 billion. There is clear evidence that the increased cost of cancer care translates to financial hardship. This hardship is widespread, impacting as many as 75% of patients and their families with associated adverse sequelae. Growing recognition of the negative impact of cancer-related treatment costs on patients and their families led to the creation of the term "financial toxicity". The present editorial is borne out of the need to bring this problem to the attention of practicing surgeons, as to the best of our knowledge is still underreported in our specialties.

  PublisherOA PDFDOI

Frequent coauthors

• Dan G. Blazer

  Duke Medical Center

  29 shared

• Rachel A. Greenup

  Yale Cancer Center

  22 shared

• Scott T. Hollenbeck

  Duke Medical Center

  20 shared

• Samantha M. Thomas

  Duke University

  17 shared

• Amanda R. Sergesketter

  Duke Medical Center

  15 shared

• Ronnie L. Shammas

  Duke University

  13 shared

• Karenia Landa

  Duke University

  12 shared

• Sabino Zani

  Duke Medical Center

  12 shared