Breast cancer is the most common cancer among women, affecting approximately 200,000 every year in the United States. Because of increased awareness and screening, many women are diagnosed early.
Surgery remains the primary treatment for most women with early-stage breast cancer. The two main options are mastectomy (complete breast removal) and lumpectomy (just the tumor and surrounding tissue are removed). It’s important to talk with your doctor about which option is best for you based on your unique diagnosis. Multiple studies have shown that lumpectomies can be just as effective as mastectomies.
One of the biggest considerations with lumpectomy surgery is the possible need for repeat surgery, or re-excision. While digital mammography, MRI and other imaging can identify the extent of tumor, the surgeon still cannot see all of the cancer while in the operating room. Nationally, it has been reported that in women undergoing lumpectomy, 20 to 50 percent require additional surgery to obtain clear margins.
Lumpectomy is usually performed as an outpatient surgery, and involves removal of the tumor along with a rim of surrounding normal breast tissue – the margin. Clear margins are important to reduce the rate of cancer recurrence.
The MarginProbe device recently was approved by the FDA as an addition to standard pathology testing for patients with breast cancer who are undergoing lumpectomies. While pathologists can see cancer cells under the microscope once the tumor is removed, cancer cells are not visible to surgeons during the actual lumpectomy. MarginProbe technology changes that. An electromagnetic sensor detects differences between normal cells and cancer cells.
In April 2013, thanks to a grant from our Foundation, we were fortunate to acquire the MarginProbe at Providence Saint Joseph Medical Center in Burbank, California.
While initial research is still small, (clinical trials tested 664 patients in the US and Israel) findings are optimistic and encouraging in the treatment of breast cancer. When used by the surgeon at the time of lumpectomy, studies have shown that the rate of positive margins and need for re-excision decreases by as much as 50 percent. Be advised, however, that the MarginProbe may overestimate the presence of cancer cells in the breast tissue, resulting in removal of healthy tissue.
In our experience, in the first two months, we have used this tool in 12 lumpectomy cases. Two of those cases resulted in readings that prompted removal of additional tissue so that repeat surgery was not necessary.
The MarginProbe is not a substitute for the pathologist’s microscope or clinical judgment, but rather is another tool to aid in the accurate assessment of surgical margins. It’s important to have a conversation with your treatment team to determine which course of action is appropriate for you.