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​​​​Sandra L. Howell, M.D., F.A.C.S.
Assistant Professor of Surgery


Surgical Disciplines

Clinical Specialty: General Surgery, Specializing in the Treatment of Benign and Malignant Breast Disease

1280 S. East Campus Drive, CMED 2405
Mount Pleasant, MI 48859
howel1sl@cmich.edu
Phone: 989-772-6880 (office)
Fax: 989-772-6817

Howell Breast Surgical Services
2981 Health Parkway, Suite B
Mount Pleasant, MI 48858

College of Medicine Roles:
Co-Director, Gastrointestinal Course Block, Year 2 Co-Director, Hematology-Oncology Course Block, Year 2 Member, Foundations Course Block Team, Year 1 Member, Case Writing Group
  


Sandra Howell, M.D., General Surgeon, has been a leader in the delivery of specialized breast care in the Central Michigan region for more than 15 years. She was the first General Surgeon in the area to become trained in ultrasonography in 1996, and purchased office ultrasound equipment, a useful tool in the evaluation of abnormal findings detected on clinical breast examination and mammogram.

Dr. Howell was also the first mid-Michigan practitioner to offer minimally invasive, ultrasound-guided, vacuum-assisted, core biopsy and was instrumental in the development of the minimally invasive, stereotactic, mammography-guided, core breast biopsy and sentinel lymph node biopsy programs at Central Michigan Community Hospital. Dr. Howell also championed the use of breast MRI in specific clinical situations. Her support of this diagnostic modality was an important factor in the decision by the local hospital to purchase the equipment needed to offer a diagnostic breast MRI service as well as MRI-guided, minimally invasive, vacuum-assisted core biopsy. Dr. Howell has offered breast conservation options to her patients, as an alternative to mastectomy, throughout her practice career, when appropriate, and has adopted the use of oncoplastic surgical techniques.

Many of Dr. Howell's patients are well persons who present for breast health maintenance checks, including screening clinical breast examinations, review of mammogram images, performance of clinical breast ultrasound, when indicated, and breast cancer risk assessment. Her practice was one of the first practices in the region to offer testing for the genetic mutations on the genes known as BRCA1 and BRCA2. She also offers risk management counseling to women who have an increased risk of breast cancer, due to a prior history of atypical cells found on biopsy, or a strong family history of breast cancer, without any association with a defined genetic mutation. Dr. Howell was an early adopter of the tumor molecular marker testing available to women and men who have been diagnosed with breast cancer, Oncotype Dx. The results of this test help to identify those patients who will benefit the most from chemotherapy and those who can potentially avoid chemotherapy or radiation therapy.

Dr. Howell's clinical practice was the first clinical practice to be acquired by Central Michigan University College of Medicine. She will continue to provide excellent breast health care, serving patients throughout central Michigan and leadership in promoting "best practice" breast care throughout the region.

Dr. Howell has taken on an educator role at the College of Medicine, primarily on the West Campus in Mt. Pleasant. She will serve as co-director of the Gastrointestinal Course Block and co-director of the Hematology-Oncology Course Block and is participating in the course design of the Foundations Course Block.

Dr. Howell has a long-standing interest in medical education. She was an assistant professor of Surgery, with resident teaching responsibilities, in Kansas City, Missouri, after she completed her residency. Since her tenure in Mt. Pleasant, she has served as an adjunct faculty and surgery course director in the CMU Physician Assistant program, as well as a proctor in the clinical arena for PA students. She is participating in a Case Writing Group in the College of Medicine that will work on developing problem-based and team-based case studies to be used during student's early learning experiences.

In her position, Dr. Howell will also develop a clinical research program. She has an interest in "translational research" and has submitted a research proposal to the NIH outlining the planning phase of a systematic approach to look at, and improve, the speed of adoption of best practice breast health care in non-tertiary care community hospitals. Cooperative partnerships between the College of Medicine and Thunder Bay Health Care Services in Hillman, and Health Delivery Incorporated, in Saginaw, and the Michigan Health Information Alliance in Midland, have already been formed to begin this work. Dr. Howell is looking forward to helping develop many more health care partnerships throughout the College of Medicine service area to assist in this, and other, translational research projects.

Dr. Howell researched, and implemented, an electronic medical record in the outpatient, private practice setting, well ahead of most other small, private, outpatient practices. She has maintained office records electronically since 2005. Dr. Howell was a "physician-developer" of her electronic medical record, working with EMR vendor to develop templates that were subsequently used by other practices using the same vendor. Dr. Howell currently serves on a committee that is seeking to develop an EMR system that will be used by early learners at the College of Medicine. This system will help students track their cases, will help faculty assess student's progress, and will be used as an aid in developing critical thinking skills.

Education & Fellowships:
  • Residency Training
    • University of Missouri
      St. Luke's Hospital
      Kansas City, MO
      1991
  • Internship
    • University of Missouri
      St. Luke's Hospital
      Kansas City, MO
      1987
  • ​Medical School
    • University of Missouri
      Columbia, MO
      1986
  • Undergraduate
    • Central Michigan University
      Majors: Chemistry, English
      Mt. Pleasant, MI
      1979
Certifications
  • Diplomate, American Board of Surgery
Specialty Interests:
Treatment of Benign and Malignant Breast Disease, Breast Cancer Risk Counseling and Management, Minimally Invasive Surgical Techniques, Cryotherapy, Oncoplastic Surgery Techniques, Translational Research: Transitioning Proven New Technology/Therapeutics from Tertiary Health Centers to Community Health Care Settings, Clinical Practice Application of Electronic Medical Records in the Outpatient Setting, Curriculum Development, Problem Based Learning, Team Based Learning, Course Development, Case Writing, Utility of Electronic Medical Records in Early Medical Education and the Use of Electronic Medical Records as a Tool to Develop and Enhance Critical Thinking, Networking Rural Health Providers to Improve Rural Health Care and Community and Rural Physician Practice Satisfaction

Awards & Honors:
  • Distinguished Alumnus Award, 2002 – 2003
    • The Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University
  • First Place Winner, Resident's Competition for Research, May 1991
    • Missouri Chapter, American College of Surgeons, Development of a Rat Model for Small Bowel Transplantation
  • Ferdinand C. Helwig Fellowship Award, 1988
    • Funding for a Month of Training in Surgical Intensive Care and Surgical Nutrition Working with Dr. Stanley J. Dudrick, St. Luke's Hospital, Houston, TX
Professional Memberships:
  • Fellow, American College of Surgeons
  • Michigan Chapter of the American College of Surgeons
  • American Medical Association
  • Michigan State Medical Society
  • Isabella/Clare County Medical Society
  • American Society of Breast Surgeons
  • American Association of Medical Colleges, Group on Women in Medicine
  • National Rural Health Association
Institutional Memberships:
  • Interim Executive Committee of Central Michigan University's College of Medicine
  • Interim Faculty Group Practice Executive Board
  • Senator Representing the CMU College of Medicine, CMU Academic Senate
  • CMU College of Medicine Faculty Recruitment Committee
  • CMU College Surgical Discipline's Chair Recruitment Committee
Hospital Affiliations & Activities:
  • Member, Medical Staff, McClaren Central Michigan Hospital
  • Chairman, Cancer Committee, McClaren Central Michigan Hospital
  • Member, McClaren Central Michigan Hospital Tumor Board
Community Roles & Volunteer Services:
  • Founding Member, Circle of Hope, Breast Screening Assistance Program
  • Co-Medical Director, Community Cancer Services of Isabella County
Volunteer Services:
  • Specialist Accepting Referrals from the Community Free Clinic
  • Participant Provider with the "Breast and Cervical Cancer Control Project"
Treatment & Services:
  • Well Person Breast Health Maintenance Program
  • Assessment of Breast Cancer Risk
  • Risk Counseling
  • BRCA 1 and BRCA 2 Sample Attainment and Submission to Laboratory
  • Review of Mammogram Images
  • Clinical Breast and Axillary Examination
  • Assessment of Skin Lesions of the Breasts, Axillae and Chest
  • Excision of Skin Lesions of the Breasts, Axillae and Chest
  • Corrective Surgery for Inverted Nipples
  • Repair of Nipple after Nipple Piercing
  • Treatment of Hidradenitis of the Breast
  • Excision of Accessory Nipple(s)
  • Evaluation and Counseling Regarding Gynecomastia
  • Surgical Treatment of Gynecomastia
  • Wound and Scar Revision, Breast
  • Breast Ultrasound Examination
  • Ultrasound-guided Fine Needle Aspiration
  • Ultrasound-guided Core Breast Biopsy
  • Stereotactic (Mammography-guided) Core Breast Biopsy
  • MRI-guided Core Breast Biopsy
  • Open Incisional Breast or Axillary Biopsy, Benign and Malignant
  • Open Excisional Breast or Axillary Biopsy, Benign and Malignant
  • Cryotherapy of Benign Breast Lesions
  • Nipple Duct Exploration
  • Nipple Duct Cytology – Sample Attainment
  • Ultrasound Wire Localization of Breast Lesions Prior to Surgery
  • Mammogram Wire Localization of Breast Lesions Prior to Surgery
  • MRI Wire Localization of Breast Lesions Prior to Surgery
  • Counseling Regarding Choice of Surgical Treatment for Breast Cancer
  • Breast Conserving Breast Cancer Surgery (Wide Excision Lumpectomy)
  • Injection of Technetium Sulphur Colloid per Sentinel Node Biopsy Protocol
  • Axillary Sentinel Lymph Node Biopsy
  • Axillary Lymph Node Dissection
  • Mastectomy: Simple, Total, Modified Radical, Radical
  • Oncoplastic Surgical Techniques
  • Attainment and Counseling Regarding Tumor Profile (eg.: OncotypeDx)
  • Patient Education Regarding Reconstructive Options
  • Lymphedema Evaluation and Coordination of Care with Physical Therapy
  • Coordination of Care with Plastic Surgeon</Coordination of Care with Medical and Radiation Oncology
  • Placement of Central Venous Catheter/Port for Administration of
  • Chemotherapy
  • Breast Health Maintenance Program
Specialty in Diseases and Conditions:
  • Well Person Breast Health Maintenance
  • Benign Breast and Axillary Disease: Skin Lesions, Cellulitis, Mastitis, Breast Abscess, Periareola Fistula, Fibrocystic Breast Changes, Breast Pain, Costochondritis, Benign Mastopathy, Nipple Discharge, Galactorrhea, Benign Breast Mass, Fibroadenomata, Axillary Mass, Ectopic Breast Tissue, Axillary Adenopathy, Gynecomastia, Hidradenitis Involving the Axilla and/or Lower Mammary Fold
  • Breast Cancer Screening
  • Breast Cancer Risk Assessment and Risk Management Counseling
  • Family History of Breast Cancer, Negative for Genetic Mutation
  • BRCA 1 or BRCA 2 Mutation Positive Family Member
  • BRCA 1 or BRCA 2 Mutation Carrier
  • Suspicious Finding on Breast Examination
  • Suspicious Finding on Mammogram
  • Suspicious Finding on Breast Ultrasound
  • Suspicious Finding on Breast MRI
  • Premalignant, High Risk Breast Tissue Cytology on Biopsy: Atypical Ductal Hyperplasia, Atypical Lobular Hyperplasia
  • Ductal Carcinoma in Situ, Lobular Carcinoma in Situ
  • Invasive Ductal Carcinoma of the Breast
  • Invasive Lobular Carcinoma of the Breast
  • Local/Regional Breast Cancer Metastasis
  • Inflammatory Breast Cancer
  • Synchronous Breast Cancers
  • Locally Advanced Breast Cancer
  • Breast Cancer Survivor Health Maintenance
Industry Relationships:

Myriad Laboratories:Laboratory Testing for BRCA 1 and BRCA 2
Genomic Health:Oncotype Dx, Molecular Profiling of Tumors
Hologic: Supplier of Core Biopsy Equipment and Supplies
Aloka:Supplier of Ultrasound Equipment
Henry Schein:Supplier of Clinical Supplies
PBOmd:EMR vendor
AdvancedMD:Practice management vendor

Languages Spoken:
  • French
  • English