Feature | Breast Imaging | April 24, 2019 | By Greg Freiherr

Productivity and Patient Benefits May Come From Wire-free Lumpectomy

Vendors at Breast Imaging Symposium describe alternatives to wire implantation

The Cianna Medical Savi Scout Radar Localization system, showing the console, detector and the marker, with a size comparison and X-ray images inside breast tissue. For more information on the learning curve of its use http://sabcs16.posterview.com/nosl/p/P1-11-06.

The Cianna Medical Savi Scout Radar Localization system, showing the console, detector and the marker, with a size comparison and X-ray images inside breast tissue. For more information on the learning curve of its use http://sabcs16.posterview.com/nosl/p/P1-11-06.

This image shows the marker with a dime for size comparison. Graphic of marker courtesy of Cianna Medical

This image shows the marker with a dime for size comparison. Graphic of marker courtesy of Cianna Medical

Greg Freiherr

Greg Freiherr

Wires have traditionally been placed prior to lumpectomy to mark cancerous tissues in the breast. Wire-free localizers, however, provide alternatives. And their clinical applications may expand.

On the exhibit floor of the Society for Breast Imaging (SBI)/American College of Radiology (ACR) Breast Imaging Symposium in Hollywood, Fla., two vendors described replacements for the wires that cancer surgeons have for years relied on to guide them to potentially malignant breast tissue.

At the symposium, Cianna Medical featured the implant of a tiny radar reflector in place of a wire. Leica Biosystems’ Mammotome showcased a magnetic seed for implantation, as well as a magnetic liquid injectable that accumulates in the sentinel lymph node, which surgeons may remove from patients undergoing mastectomy. The FDA has approved the Mammotome tracer for use specifically in patients undergoing mastectomy for breast cancer.

Providers may choose another type of breast cancer localizer, a product obtained last year by Hologic through its acquisition of Faxitron Bioptics. The device uses a miniature radiofrequency tag designed to be implanted in the breast and reside there for more than 30 days prior to surgery.

 

How Eliminating Wires Can Benefit Patients And Hospital Staff

Patients undergoing lumpectomy, a surgical procedure common in breast conservation, traditionally have wires implanted to guide the surgeon to the cancer. These wires, however, can restrict the activities of patients, as well as those of physicians.

The wires, which protrude from the breast, can keep patients from going home. Consequently, they may have the wires implanted the morning of surgery. Radiologists must arrange their schedules to do the implantations the same day as the lumpectomies. And surgeons who depend on the wires must schedule procedures after implantation. Any delay in the implantation may cause problems for the surgeons as well as scheduling the operating room.

“So not only is (wire-free localization) better for the patient, it is more efficient,” said Mike Numamoto, vice president of marketing for Cianna Medical, which makes the Savi Scout Radar Localization system.

On the exhibit floor of the breast imaging symposium, Cianna showcased productivity and efficiency gains that might be derived from the use of the Scout system. Leica Biosystems/Mammotome focused on the utility of its injectable tracer, which is engineered to be uniform and small enough for rapid migration, according to the company, yet large enough to be mechanically filtered by the sentinel lymph nodes.

 

Update Increases Precision

The most recent update of Cianna’s Scout allows physicians to localize the implanted reflector to within 1 mm, according to Numamoto. The radar signal is fired by a handheld wand and reflected by the implant. The signal is then processed and displayed by the Scout console to indicate the distance between the wand and the reflector.

As used during lumpectomy, the wand may first be placed on the patient’s skin to indicate the route to and the depth of the implanted reflector. During surgery, the wand is then positioned repeatedly in the incision to indicate the distance to this device, which ultimately is removed along with the surrounding tissue.

Rather than relying on an external source transmission, Mammotome’s Sentimag probe detects magnetic fields emanating from its implanted Magseed markers or injected Magtrace Liquid. Magseed is used to localize breast tissue that the surgeon intends to remove; the liquid tracer is designed to help find the sentinel lymph node to which the breast cancer may have metastasized.

When using the liquid tracer, the magnetic field allows the surgeon to home in on the lymph node; its dark color offers visual confirmation during the surgery. The current standard for identifying sentinel lymph nodes involves injecting a radioactive technetium tracer and a blue dye, according to Jodi Hafemeister, senior manager for product and marketing performance for tissue acquisition solutions at Leica Biosystems (Mammotome).

“If you want to see if the cancer has spread to the lymph node (and) you don’t know which lymph node to check, you have to map it,” Hafemeister said. “This is a radioactive-free option.”

 

Expanding The Use Of Markers In Breast Conservation

Numamoto said the use of wireless localizers in patients seeking breast conservation is entering a new phase of advanced utilization. One such example may involve the placement of wire-free markers before the administration of chemotherapy or radiation. Early placement may be indicated, he said, because such neoadjuvant therapy can shrink the breast tumor, making it difficult to localize.

Savi Scout might also be implanted at the time of biopsy, according to Numomoto, if a suspicious lesion has a high likelihood of cancer. Meanwhile, the company is continuing to evolve the Scout product, for example, making the diameter of its handheld wand smaller so that it can be inserted into less intrusive incisions that minimize scarring.

 

Greg Freiherr is a contributing editor to Imaging Technology News (ITN). Over the past three decades, Freiherr has served as business and technology editor for publications in medical imaging, as well as consulted for vendors, professional organizations, academia, and financial institutions.

 

Related Content:

Merit Medical Completes Acquisition of Cianna Medical

Leica Biosystems Acquires Devicor Medical Products

Hologic Acquires Digital Specimen Radiography Company Faxitron Bioptics

Related Content

A patient prepares to have a tomosynthesis-guided prone breast biopsy using the Hologic Affirm prone biopsy system.

A patient prepares to have a tomosynthesis-guided prone breast biopsy using the Hologic Affirm prone biopsy system.

Feature | Breast Biopsy Systems | October 17, 2019 | By Harriet Borofsky, M.D.
The current body of research supporting...
Guerbet Signs Agreement With Icometrix for Exclusive Distribution of Icobrain
News | Neuro Imaging | October 16, 2019
Guerbet announced it has signed an exclusive agreement with Icometrix for the distribution in France, Italy and Brazil...
Subtle Medical Receives FDA 510(k) Clearance for AI-powered SubtleMR
Technology | Artificial Intelligence | October 16, 2019
Subtle Medical announced 510(k) clearance from the U.S. Food and Drug Administration (FDA) to market SubtleMR. SubtleMR...
Feature | Artificial Intelligence | October 16, 2019 | By Siddharth (Sid) Shah
The period between November through February is pretty interesting for the field of medical imaging — two major confe
Feature | Breast Imaging | October 16, 2019 | By Jeff Zagoudis
On Jan. 1, 2017, the U.S.
Genia Sutton, intGenia Sutton, interim director of radiology

Genia Sutton, interim director of radiology, has seen the benefit to patients. “Five minutes is a lot of time if you are thinking you may have breast cancer,” she said. “Now, technologists aren’t as rushed. They can give a more personal touch because they can spend more time with their patients.”

Sponsored Content | Case Study | Mammography | October 10, 2019
When Cullman Regional Medical Center in Alabama decided to
As the role of artificial intelligence continues to expand, many companies are making significant investments in this technology to offer solutions
Feature | Artificial Intelligence | October 09, 2019 | By Sharmistha Sarkar
Artificial intelligence (AI) is a technology
RSNA Announces Intracranial Hemorrhage AI Challenge
News | Artificial Intelligence | October 08, 2019
The Radiological Society of North America (RSNA) recently launched its third annual artificial intelligence (AI)...
An illustration of radiology department analytics data showing GE Healthcare's business analytics software.
Feature | Radiology Business | October 08, 2019 | April Wilson
According to IBM, the world creates 2.5 quintillion bytes of data daily.
Hologic, Inc.’s Company’s Chairman, President and Chief Executive Officer Steve MacMillan, joined a number of employees to ring the Nasdaq Opening Bell for the 14th consecutive year on Oct. 2
News | Women's Health | October 04, 2019
Hologic, Inc.’s Company’s Chairman, President and Chief Executive Officer ...