Scholars@Duke
Gayle Ackerman DiLalla

Gayle Ackerman DiLalla

Assistant Professor of Surgery
Surgical Oncology

Selected Publications

Contemporary Trends in Axillary Surgery for ER-Positive, HER2-Negative Breast Cancer Stratified by Neoadjuvant Endocrine Therapy, Neoadjuvant Chemotherapy, or Upfront Surgery.

Journal Article Ann Surg Oncol · January 2026 BACKGROUND: De-escalation of axillary surgery for hormone receptor-positive breast cancer has gained traction, but guidelines for axillary management after neoadjuvant endocrine therapy (NET) remain ill-defined. METHODS: Female patients age ≥50 years with ... Full text Link to item Cite

Radiation De-Escalation in Older Women with Early-Stage ER+/HER2- Invasive Breast Cancer.

Journal Article Ann Surg Oncol · November 23, 2025 BACKGROUND: National recommendations since 2004 have allowed for omission of post-lumpectomy radiotherapy for patients ≥70 years old with early-stage estrogen receptor positive (ER+)/human epidermal growth factor receptor 2-negative (HER2-) breast cancer. ... Full text Link to item Cite

Abstract P2-10-05: Survival in Older Women Receiving Adjuvant Radiation Monotherapy vs. Endocrine Monotherapy Following Lumpectomy

Conference Clinical Cancer Research · June 13, 2025 AbstractBackground: Breast cancer is increasingly prevalent in women over 65, and most are diagnosed with hormone receptor positive disease. While younger patients with early-stage breast cancer are treated ... Full text Cite

Adjuvant Radiation vs Endocrine Therapy After Lumpectomy for Early-Stage Breast Cancer in Older Women: Analysis of Real-World Survival Outcomes.

Journal Article Ann Surg Oncol · June 6, 2025 BACKGROUND: We examined whether adjuvant radiation therapy (RT) monotherapy offers comparable overall survival (OS) to adjuvant endocrine therapy (ET) monotherapy following lumpectomy in women aged ≥ 65 years with favorable early stage breast cancer. PATIE ... Full text Link to item Cite

Comparison of survival outcomes for patients with Stage III vs de novo Stage IV breast cancer.

Journal Article Cancer · May 15, 2025 PURPOSE: Improvements in systemic therapy have resulted in significant heterogeneity in survival outcomes for metastatic breast cancer patients. As such, recently proposed staging guidelines for de novo metastatic breast cancer stratify patients into four ... Full text Link to item Cite

The influence of gender and virtual interviews on applicants’ evaluation of surgical residency programs: a changing landscape

Journal Article Global Surgical Education - Journal of the Association for Surgical Education · December 10, 2024 Full text Cite

Triple-Negative Breast Cancer in Older Patients: Does SLNB Guide Therapy?

Journal Article Ann Surg Oncol · December 2024 BACKGROUND: Older breast cancer patients represent a heterogeneous population. Studies demonstrate that sentinel lymph node biopsy (SLNB) omission may be appropriate in some clinical scenarios, yet patients with triple-negative breast cancer (TNBC) are oft ... Full text Link to item Cite

Rates of Pathologic Complete Response and Overall Survival in Patients with Inflammatory Breast Cancer: A National Cancer Database Study.

Conference Ann Surg Oncol · November 2024 BACKGROUND: Patients with inflammatory breast cancer (IBC) have worse survival compared with stage III non-IBC matched cohorts; however, the prognostic significance of achieving pathologic complete response (pCR) in the setting of IBC is not well described ... Full text Link to item Cite

Assessment of Treatment Sequence in Patients With Stage III Breast Cancer.

Journal Article J Surg Res · October 2024 INTRODUCTION: Stage III breast cancer is defined as locally advanced breast cancer and is treated with curative intent. Historically, overall survival (OS) did not differ based on treatment sequence (neoadjuvant chemotherapy [NAC] followed by surgery versu ... Full text Link to item Cite

A prognostic model for use before elective surgery to estimate the risk of postoperative pulmonary complications (GSU-Pulmonary Score): a development and validation study in three international cohorts.

Journal Article Lancet Digit Health · July 2024 BACKGROUND: Pulmonary complications are the most common cause of death after surgery. This study aimed to derive and externally validate a novel prognostic model that can be used before elective surgery to estimate the risk of postoperative pulmonary compl ... Full text Link to item Cite

Anatomy Versus Biology: What Guides Chemotherapy Decisions in Older Patients With Breast Cancer?

Journal Article J Surg Res · April 2024 INTRODUCTION: With the increasing utilization of genomic assays, such as the Oncotype DX recurrence score (RS), the relevance of anatomic staging has been questioned for select older patients with breast cancer. We sought to evaluate differences in chemoth ... Full text Link to item Cite

A review of professionalism in surgery.

Journal Article Proc (Bayl Univ Med Cent) · 2024 Physicians, and specifically surgeons, have unique expectations and responsibilities regarding professionalism. Further, surgeons interact with multiple different groups of people including surgical peers, trainees, other physicians, ancillary care partner ... Full text Link to item Cite

Neoadjuvant Chemotherapy and Endocrine Therapy for Older Patients with Estrogen Receptor Positive Breast Cancer: Comparison of Approaches.

Journal Article Ann Surg Oncol · October 2023 BACKGROUND: Benefits of a pathologic complete response (pCR) following neoadjuvant therapy are well established, yet outcomes for older women are understudied. We sought to examine the pCR and overall survival (OS) rates of women with estrogen receptor (ER ... Full text Link to item Cite

The Influence of Body Mass Index on the Histopathology and Outcomes of Patients Diagnosed with Atypical Breast Lesions.

Conference Ann Surg Oncol · October 2022 BACKGROUND: Multiple studies have demonstrated a link between obesity and breast cancer; however, the potential association between obesity and atypical high-risk breast lesions has not been well characterized. We sought to evaluate the characteristics and ... Full text Link to item Cite

Disease characteristics and mortality among Asian women with breast cancer.

Conference Cancer · March 1, 2022 BACKGROUND: Asian women with breast cancer are often studied in aggregate, belying significant intragroup diversity. The authors sought to examine differences in breast cancer characteristics and outcomes among Asian women. METHODS: Asian, non-Hispanic Bla ... Full text Link to item Cite

Utilization of neoadjuvant chemotherapy in high-risk, node-negative early breast cancer.

Journal Article Cancer Med · February 2022 BACKGROUND: Controversy exists regarding the optimal sequence of chemotherapy among women with operable node-negative breast cancers with high-risk tumor biology. We evaluated national patterns of neoadjuvant chemotherapy (NACT) use among women with early- ... Full text Link to item Cite

Metastatic breast cancer: Who benefits from surgery?

Journal Article Am J Surg · January 2022 BACKGROUND: We sought to identify characteristics of metastatic breast cancer (MBC) patients who may benefit most from primary tumor resection. METHODS: Recursive partitioning analysis (RPA) was used to categorize non-surgical patients with de novo MBC in ... Full text Link to item Cite

Death following pulmonary complications of surgery before and during the SARS-CoV-2 pandemic.

Journal Article Br J Surg · December 1, 2021 BACKGROUND: This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. METHODS: This was a patient-level, comparative analysis ... Full text Link to item Cite

Survival Outcomes Among Patients with Metastatic Breast Cancer: Review of 47,000 Patients.

Conference Ann Surg Oncol · November 2021 BACKGROUND: Although metastatic breast cancer (MBC) remains incurable, advances in therapies have improved survival. Using a contemporary dataset of de novo MBC patients, we explore how overall (OS) and cancer-specific survival (CSS) changed over time. MET ... Full text Link to item Cite

Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study.

Journal Article Lancet Oncol · November 2021 BACKGROUND: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during ... Full text Link to item Cite

Mortality in Older Patients with Breast Cancer Undergoing Breast Surgery: How Low is "Low Risk"?

Conference Ann Surg Oncol · October 2021 BACKGROUND: Breast surgery carries a low risk of postoperative mortality. For older patients with multiple comorbidities, even low-risk procedures can confer some increased perioperative risk. We sought to identify factors associated with postoperative mor ... Full text Link to item Cite

Characterizing participants in the North Carolina Breast and Cervical Cancer Control Program: A retrospective review of 90,000 women.

Conference Cancer · July 15, 2021 BACKGROUND: The North Carolina Breast and Cervical Cancer Control Program (NC BCCCP) provides breast cancer screening services to underserved women to mitigate disparities in access to care. The authors sought to characterize this understudied population. ... Full text Link to item Cite

Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.

Journal Article Br J Surg · January 27, 2021 BACKGROUND: Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer sur ... Full text Open Access Link to item Cite

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

Journal Article J Clin Oncol · January 1, 2021 PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with ... Full text Link to item Cite

It's not you, It's me: The influence of patient and surgeon gender on patient satisfaction scores.

Journal Article Am J Surg · November 2020 BACKGROUND: Surgeons face the unique challenge of being responsible for both clinical encounters and surgical outcomes. We aim to explore how patient evaluations of surgeons may be influenced by patient and provider factors. METHODS: Patient responses from ... Full text Link to item Cite