By Sam Elliott
A pair of new technologies —which some experts predict will become the mainstream methods of locating and analyzing cancerous legions — are making their area debut at the St. Vincent Carmel Women’s Center.
Dr. Erica Giblin, a breast surgeon at the hospital, has been using both new technologies — radioactive seed localization and MarginProbe — since earlier this summer. The St. Vincent Carmel Women’s Center is the first and only hospital in central Indiana to implement the new technologies.
“We just started utilizing this new technology in July and we’ve done quite a few of these procedures,” Giblin said. “Most of the patients say that localization was actually easier than the biopsy they had to go through in the radiology department to determine their cancer.”
Noblesville resident Debbie Bush was diagnosed with breast cancer in January, and chemotherapy treatment left her cancer-free. When it came time to take a tissue sample to confirm her cancer’s disappearance, the radioactive seed localization procedure replaced one using a wire latched onto the cancerous area.
“The wire is long, sometimes it enters the skin remote from where the actual legion is, so in theory you could cut in the wrong space and then you’ve got to tunnel down quite far to get to the actual legion,” Giblin said. “So from a cosmetic standpoint, that’s not great, and from an accuracy standpoint it might not be great.”
Patients have been known to faint at the sight of the wire coming out of their skin, but the new procedure is less of a burden for patients and more accurate for doctors.
“Sometime the breast tissue can be super fatty so it’s like Jell-O, then you worry when you’re dissecting down that the wire might move… If it’s in the wrong spot, you’re taking out the wrong spot. That’s not good for the surgery or patient,” Giblin said. “Sometimes the breast tissue is so dense it’s almost like concrete. When you’re trying to find that wire down, you actually can’t feel where that thing is going.”
The new procedure begins with a radiologist using ultrasound or mammogram technology and to put a needle directly in the center of the targeted cancerous region.
“They deposit this little seed right in that area. In the [operating room], I have this probe that acts like a homing device. You put it on the breast and it starts beeping,” Giblin said. “I can make my incision directly over that area and I can get right down accurately to that area taking minimal tissue.”
Weighing her options, Bush said it was easy for her to decide on the radioactive seed procedure versus the traditional method involving an exposed wire.
“I chose that because I felt like that would make her job easier,” Bush said. “My tumor had shrunk completely so she needed to know where to go exactly to go where that cancer had originated to get the tissue she needed.”
Once Giblin has the tissue she needs, she can make use of the hospital’s other new technology — MarginProbe — which can help prevent additional surgeries.
“When we take the lump of tissue, it’s like a circle in six dimensions — we take a mammogram picture of it to make sure the legion is in the center of that circle,” Giblin said. “However, we don’t know microscopically if little tumor cells are expanding to the surface or the margin of the specimen. So we try our best to analyze it in the [operating room]with this new technology. It’s a probe you put on the surface of the specimen and it analyzes all six areas of the specimen and it can tell us if the edge is positive with tumor cells or negative.”
Without the technology, patients could have to return for additional surgery the following week if microscopic tumor cells were spreading.
“With both of these technologies together, they’re showing they can decrease the rate of having to take a woman back for re-incision if there was a positive tumor by up to 50 percent,” Giblin said. “That’s a huge number.”