More precise lumpectomies

Upstate breast surgeons Ranjna Sharma, MD, (left) and Lisa Lai, MD.

The reflector is about the size of a grain of rice.

BY EMILY KULKUS

Breast cancer surgeons at Upstate University Hospital use a new technology called Savi Scout that makes locating and removing tumors and lesions easier and more precise.

Savi Scout involves inserting a tiny sensor called a reflector into a tumor or abnormality in the breast that cannot be felt from the outside. The reflector is about the size of a grain of rice and uses safe, nonradioactive radar waves to signal where it is located. This offers surgeons and their patients two big advantages over existing wire localization technology: The reflector can be inserted many days prior to surgery, and it does not involve wires protruding from the body, which can be uncomfortable and are at risk of moving.

“For many patients, the reflector is more comfortable, less anxietyprovoking and also saves time on the day of surgery,” said Ranjna Sharma, MD. She is chief of breast surgery at Upstate. “We felt these were important benefits to offer to our patients.”

The typical wire localizers need to be inserted just prior to surgery in the radiology department, which is separate from where the surgery occurs. That procedure adds additional time – usually about an hour for the procedure as well as travel time between departments –beforehand. Wire localization involves having several inches of wire protruding from the breast, which the surgeon follows to locate the tumor. The wires can be uncomfortable and can sometimes move, which can make finding the tumor in surgery more challenging, Sharma said.

Instead, the reflector is inserted using a long, thin, metal device similar to biopsy equipment, and it cannot be felt once inside the breast. It also should not move, Sharma said.

The breast surgeon uses a probe on the surface of the skin to detect where the reflector is and guide the incision. This can also help the cosmetic success of the procedure, Sharma said.

The Savi Scout can be detected up to 6 centimeters deep, which means for some patients with deeper tissue or tumors, the wire localization technique will still be necessary. The goal is to remove the reflector with the tumor or lesion; it can be used with cancerous and noncancerous tumors and lesions as well as lymph nodes. Two reflectors may also be used on one large tumor if necessary, Sharma said.

Upstate breast surgeon Lisa Lai, MD, said the precision of the new technology helps surgeons accurately remove cancerous tissue while also preserving healthy tissue. “The device increases the precision of a lumpectomy by guiding the surgeon to the exact tumor location and telling the surgeon the actual distance to the tumor,” Lai explained.

“The goal of a lumpectomy for breast cancer is to remove the tumor with a normal rim of breast tissue around it, so the edges of the tissue are free of cancer. Research shows that use of this device improves success of the operation by increasing the chance that the tumor will be fully removed and thus decreasing the chance of needing a second operation to remove more tissue,” Lai said.