Q&A Topic: A Targeted Breast-Conserving Option for Women
Alice Police, MD FACS
Q. What should women know about breast surgery today?
A. Surgeons are doing a lot more breast-conserving surgeries today and treating early breast cancers due to improved imaging. We’re not doing mastectomies as much anymore—we’re saving the breast. To do accurate breast-conserving surgery, we need to know exactly where the problem is so we can take out the cancer and leave as much healthy tissue as possible.
Q. What technology are you using to help pinpoint tumors?
A. At Northern Westchester Hospital and Phelps Hospital we’re using SAVI SCOUT technology to target, or localize, tissue that needs to be removed. It’s the first-ever use of radar in the human body—like a GPS for the breast. It helps us go straight to an abnormality very precisely. It tells us exactly where something is in the breast that we need to take out. It’s mostly for breast cancer surgery, but also for removing benign lesions.
Q. How does it work?
A. A radiologist uses a needle to implant a little device called a “reflector” into the breast, showing the tissue that needs to be removed. The reflector is very tiny and skinny—1.1 centimeters long—and the patient can’t feel it. It’s made of metal and has little antennae; it looks like a teeny little airplane. The reflector is also MRI-compatible and doesn’t go off at airport monitors.
Q. How does this compare to using traditional wire localization?
A. It’s more accurate and it’s also easier on the patient. When a wire is used to locate a tumor, a radiologist must put it in the breast on the same day as surgery. The patient has to come in hours early and sit around with this wire hanging out, waiting for surgery. The surgeon then uses the wire as a guide to the tumor. With SAVI SCOUT, the reflector can be put in any time prior to surgery—it takes five minutes. The patient doesn’t have to wait around on the day of surgery, and we can do the procedure earlier in the day, which is always better for the patient. Patients have less anxiety because of shorter waiting times. If you add up surgeries for both breast cancers and benign lesions, it’s probably up to 70,000 women a year who can potentially use this technology—instead of wires. That’s a lot.
Q. How do you use SAVI SCOUT during surgery and what’s the outcome?
A. In the operating room, I have a console connected to a flexible wand to help guide me through surgery. The wand sends an infrared light into the reflector, which turns it on, and then the reflector starts emitting a signal that’s picked up by the wand. There’s a continuous readout on the console of how far I am from the reflector, directing me straight to the lesion. During the procedure I remove the abnormality and the reflector. Overall, women have an easier recovery with SAVI SCOUT. I make smaller incisions because I go straight to the lesion. And I remove less normal tissue, so it’s better cosmetically for the patient.
Alice Police, MD FACS
Regional Director of Breast Surgery, Northwell Health