Armando E. Giuliano

Armando E. Giuliano

Armando Elario Giuliano is a surgical oncologist, surgeon scientist and surgical professor in Los Angeles, California, United States of America.He is the Linda and Jim Lippman Chair in Surgical Oncology and co-director of Saul and Joyce Brandman Breast Center at Cedars Sinai Medical Center, Los Angeles.

Early Life and Education

Giuliano was born in Long Island, New York in 1947 where he completed his primary education. He went to Fordham University in Bronx, New York for college. He pursued his medical education at University of Chicago Medical School and completed his medical degree in 1973. During medical school, Giuliano worked with George Block, who later acted as an inspiration for Giuliano to pursue a career in surgery.

Training and Medical Career

Giuliano is an American Board of Surgery-certified Surgical Oncologist focusing on Breast Oncology. He completed his general surgery training at University of California, San Francisco in 1980. During training, he was initially interested in vascular surgery, "my favorite operation to this day is carotid endarterectomy”, says Giuliano in an interview with Bruce Gewertz, MD. During residency, Giuliano was recommended by the Chief of Surgery at UCSF, F. William Blaisdell, MD to pursue research fellowship in Surgical Oncology at the University of California, Los Angeles with Donald Morton, MD. It was during his time with Morton that Giuliano developed a passion for surgical oncology, “… I worked with Don and fell in love with Surgical Oncology”, says Giuliano.

Sentinel Lymph Node Biopsy

The concept of sentinel lymph node biopsy in breast surgery is one of the major contributions of Giuliano to modern day breast cancer management. He inherited the idea of sentinel node biopsy from his mentor Morton in early 1990's, who at that time was using the technique for skin melanoma. Initially, Giuliano was doubtful of the application of the technique in management of breast cancer, though upon encouragement from Morton, Giuliano decided to give it a shot, " Armando research means search again, keep trying", says Giuliano as he describes Morton's persuasion. In 1991, Morton and Giuliano founded the John Wayne Cancer Institute in Santa Monica, California. The standard of care for breast cancer surgery at that time was to remove all of the axillary lymph nodes, which was a highly morbid procedure resulting in complications such as lymphedema, chronic pain, swelling and immobility of the upper extremity. Giuliano and his then clinical fellow, Daniel Kirgan, MD sat down at a bar at the American College of Surgeons meeting and on a napkin they brainstormed several experiments to test the applicability of sentinel lymph node biopsy in breast cancer. This lead to numerous experiments and Giuliano's paper pioneering the technique of sentinel lymph node biopsy in breast cancer was published in Annals of Surgery in 1994. “We inject a blue dye into the patient’s breast tumor and look for a node that takes up the dye, the theory being, if that tumor drains first to that lymph node, it was the first one to have the cancer,” he said. This landmark paper was followed by numerous others showing that if the sentinel lymph node is negative, no more dissection is needed.

During his academic career, Giuliano has served in numerous important roles, including the President of Society of Surgical Oncology, member of Board of Directors of Alliance for Clinical Trials in Oncology, and the President of International Sentinel Node Society. He has delivered lectures on clinical oncology and tumor biology at national and international forums.