New technology makes lumpectomies more precise - NorthJersey.com

In all of life’s firsts, this was one that Rustanne Provenzano didn’t quite expect.

Not the lump found in her breast during a routine mammogram, but the way it was removed.

After an exam revealed a non-palpable, pre-cancerous lesion in her breast, Provenzano took a deep breath, knowing what was ahead for her.

“I am a nurse for the bone-marrow-and-stem-cell-transplant team at Hackensack University Medical Center,” she said. “So, I’m a little more aware of cancer than your average person.”

Like most treatments, a lumpectomy, which is what Provenzano’s lesion called for, can be an uncomfortable, dragged-out, imprecise and potentially somewhat disfiguring science, doctors say.

A radiologist typically marks the area of tissue that needs removal using guide wire — almost like fishing line with a hook at the end. This is how the breast surgeon knows what area of tissue to remove. “The problem with the guide wire is that it can move. It is also uncomfortable for the patient, watching these wires be placed in the breast,” explained Mary Jane Warden, breast cancer surgeon at the hospital.

But new technology called the SAVI SCOUT surgical guidance system became available to the public this year, making nonpalpable lumpectomies more precise and less uncomfortable. “We were part of a [Food and Drug Administration] trial,” Warden said. “We liked the results so much that we decided to purchase the system once the trial was over.”

Provenzano, of Jersey City, was happy to be a text case last October, when her pre-cancerous lesion was discovered and the technology was still on trial at Hackensack.

“I knew nothing of this,” she said. “When I was referred to a surgeon, I chose Mary Jane because I knew of her experience and her reputation. At that point in time my options were discussed, and they asked me if I would be interested in participating in this new procedure. I would be the first.

“Since I am a nurse, and I do have some medical knowledge, she added, “I know what the procedure is like when done in the traditional way. It can be hours of waiting, which can be nerve-racking.”

As Warden explain it, SAVI SCOUT entails using reflectors instead of guide wire.

“This little SAVI reflector marks the area so that we know what needs to be removed,” the surgeon said. “This newer technology is based on radar and light waves. These little chips inserted into the breast can be inserted up to a month ahead of time. When an infrared light probe is placed over where the chip is, it chirps back to the surgeon. The closer you are to the chip, the more frequent the chirp is. So you can tell when you are getting closer to it, and when you are getting farther away from it.”

Warden said there are a number of benefits to this advancement.

“Since it can be placed in the breast ahead of time,” she said, “the patient doesn’t have to come in so early the day of surgery. Because it’s such a precise localizer, we take out less tissue and leave the patient with a better cosmetic result. And because it’s so precise, the patient is less likely to come back for additional surgery.”

Provenzano said she is glad she was Warden’s test patient.

“The reason why I liked this procedure is it’s quick,” she said. “You are in and out of radiology, you get to the hospital the day of the surgery, and you go in when you’re scheduled to go in. You’re not sitting there for eight or nine hours marinating in stress and anxiety.”

Dr. Leslie Montgomery, chief of the Division of Breast Surgery at Hackensack, said: “This technology has the potential to reduce any surgical delays, improve the patient experience, optimize our surgical planning and conserve breast tissue for the patient.”

She also noted that SAVI SCOUT offers an alternative to a traditional way of marking the breast tissue that needs to be removed. It entails planting radioactive seeds along the lesion line.

“We eliminate all the disadvantages of the old wire localization technique,” Montgomery said. “In addition, we do not expose the patient to unnecessary radiation because we do not use the radioactive seed technique for localization of breast tissue.”

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