Surgeon’s Research Is Helping to Improve Breast Cancer Treatment

In In The News by Barbara Jacoby

Research presented at a national conference by well-known breast cancer expert Cary Kaufman, M.D. documents pioneering work with a small three-dimensional marker that improves the treatment of breast cancer.

Dr. Kaufman is the first surgeon in the Pacific Northwest to use the BioZorb™marker. He presented findings on his experience at the 2015 Breast Cancer Symposium, held last month in San Francisco.

The BioZorb marker is sutured in place during lumpectomy surgery just after the cancer is removed. In a lumpectomy, the cancer and a small amount of breast tissue surrounding the tumor are removed as part of breast conservation therapy. This is then typically followed by several weeks of radiation to the breast, to help prevent the cancer from returning.

The BioZorb implant is the first device that identifies in a fixed, 3D manner where the tumor was removed. By doing this, treatments and follow-up after surgery can be more precise. There are other benefits for patients as well, including better cosmetic outcomes.

“Our patients are happy with the results because the marker helps to maintain the appearance and contour of the breast after surgery,” Dr. Kaufman said. “Even though the marker is small, it adds some volume where tissue was removed during surgery, and we’ve noticed that this makes a significant difference.”

The implant structure is designed to dissolve slowly over time, and Dr. Kaufman notes that this appears to be helpful in the healing process. “We have also seen that over the course of a year or so, healthy tissue grows into the space where the device was placed. The implant itself dissolves during this extended period of time, leaving behind small clips to permanently identify the area for doctors to follow.”

By sewing the marker into the “ghost space” where the cancer was removed, Dr. Kaufman said, the surgeon can be more effective in communicating to the radiation oncologist exactly where the cancer was located. This in turn makes it possible for the radiation oncologist to be more confident in aiming the radiation treatments.

Optimal radiation targeting is important to insure the radiation is delivered to the area most likely to have a recurrence, and also to protect nearby healthy tissues from being inadvertently exposed to radiation.

The BioZorb device consists of a spiral structure made out of bioabsorbable material that holds six titanium clips. The spiral slowly dissolves in the body over the course of a year or more. The tiny marker clips stay in place so the surgical site can be identified for long-term monitoring.

At the 2015 Breast Cancer Symposium, Dr. Kaufman reported on 36 consecutive cases from May 2014 to June 2015, in which the marker was placed during a lumpectomy. He also noted positive results in follow-up mammograms: “We see in these mammograms, six months and 12 months after surgery, that there is a very nice resolution of scar tissue and very accurate identification of where the breast cancer was.”

Dr. William Hall is a radiation oncologist at the PeaceHealth St. Joseph Cancer Center who provides radiation treatment to many of Dr. Kaufman’s patients after surgery.

“The marker allows us to identify the surgical site and have even more confidence that we are hitting the target with radiation treatment,” said Dr. Hall. He noted that the marker can be used with several different methods to deliver the radiation. In some cases, patients are able to have radiation treatments that are significantly shorter than the usual six-week treatment period.

“It’s also very useful with younger patients who have dense breasts,” he said. “Sometimes with younger women, it is hard for us to see where the actual tumor was removed. Having BioZorb implanted during surgery provides a nice target for us, especially in these cases.”

Dr. Kaufman reported that he had an unusual opportunity to see how the marker helps restore tissue within the breast after a lumpectomy.

“In one case, we were able to see the area where the marker had been placed almost a year earlier. It was very interesting, because we observed the growth of healthy fibrous tissue into that space,” he said. “The marker had provided a lattice where the tissue had been removed. The process of tissue in-growth helps to add volume and achieve a better cosmetic outcome.”

Dr. Kaufman is Medical Director of the Bellingham Regional Breast Center and a nationally recognized expert on the diagnosis and treatment of breast cancer. He is also the Principal Investigator on a national clinical registry designed to advance the scientific and clinical understanding of the BioZorb marker. The new registry records the growing number of breast cancer treatments in which the marker is used. “Scientific presentations about the marker have been quite encouraging, and the registry will enable us to see various aspects of physicians’ experiences more clearly,” he said.

About Bellingham Regional Breast Center

The Bellingham Regional Breast Center provides comprehensive diagnosis and treatment for all breast disorders. Services include early diagnosis; risk analysis with genetic counseling and testing; treatment with surgery, radiation therapy, chemotherapy, endocrine therapy, targeted therapies, and immune therapy; and supportive care including counseling, physical therapy, and lymphatic massage. Because of its expertise and state-of-the-art breast care, the center serves patients throughout the region from north of Seattle to lower British Columbia.