Breast Cancer Research Says Surgical Marker Improves Therapy and Cosmetic Results

In In The News by Barbara Jacoby

Thumbnail for 9262A new surgical marker enables radiation oncologists to deliver more precise radiation therapy for breast cancer patients, according to research presented at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

The study was conducted by Robert Kuske, M.D. at Arizona Breast Cancer Specialists and researchers at two other sites. They documented physicians’ clinical experiences with a three-dimensional surgical marker (the BioZorb™ Tissue Marker, Focal Therapeutics, Inc.).

In the study of 51 cases, the FDA-cleared surgical marker was reported to result in reduced radiation treatment volumes and smaller radiation doses, for both boost and accelerated partial breast irradiation (APBI).

“Like many great innovations, the design of the new marker is relatively simple and its effects are profound,” said study co-author Robert Kuske, M.D., a breast cancer-specific radiation oncologist and co-founder of Arizona Breast Cancer Specialists. “The reduction in treatment volumes means that with this marker, women have far less risk of damage to healthy tissue during treatment, and that they can expect better cosmetic results.”

Another study result concerned use of the new marker in conjunction with oncoplastic surgery. The study found that the marker provided a “supporting structure for oncoplastic repair” that produced excellent cosmetic outcomes.

“The marker proved to have a unique ability to complement oncoplastic techniques,” said study co-author Linda Ann Smith, M.D., breast surgeon at Comprehensive Breast Care in Albuquerque, N.M. “This is due to its three-dimensional, open spiral shape. Our research showed that the marker improves cosmetic results across the board. This is especially true when combined with reconstructive oncoplastic surgery.”
Among patients in the study was Charmazel Dudt, a retired literature professor in Albuquerque, who had a lumpectomy performed by Dr. Smith, during which the new tissue marker was placed. She then traveled to Scottsdale, Ariz. to receive interstitial brachytherapy from Dr. Kuske.

“Dr. Smith told me that normally, she would have been worried about my receiving radiation because my cancer was located near my heart and I have two stents,” said Dudt. “But using this new marker made her much less concerned because my treatment was going to be very precise. That meant there was less risk of radiation damage to my heart. And, of course, that’s just how things turned out. I’m so grateful.”

Oncoplastic surgery combines plastic surgery techniques with surgical oncology methods, to help maintain the treated breast’s natural shape and contour.  While the approach can improve cosmetic outcomes for breast cancer surgery patients, it involves rearranging the patients’ own tissues. This increases the challenge of using traditional markers to accurately visualize the exact surgical site for radiation treatment.

The new surgical marker’s unique open-spiral design incorporates six permanent titanium clips in a fixed 3D array and provides specific landmarks at the site of the excised tumor. This allows the surgeon to secure the tissue to the device and use it for oncoplastic reconstruction, patient positioning, and radiation treatment planning.
The device has been used successfully in both the U.S. and New Zealand. It is made of a bioabsorbable material commonly used in other medical devices, allowing the patient’s body to absorb the material slowly so it does not require surgical removal after treatments are completed.

Dr. Kuske is an internationally known innovator in radiation therapy for breast cancer. He is the pioneer of APBI, a 5-day alternative to conventional, six-week- long whole-breast irradiation for select early-stage breast cancer patients.

Also among Dr. Kuske’s innovations is the multi-catheter APBI technique known as interstitial brachytherapy. In the study, the new tissue marker allowed radiation oncologists to use an average of 47% fewer catheters while performing interstitial brachytherapy.

The findings of the study presented at ASTRO are consistent with previous research presented at other conferences. The ASTRO meeting was held Sept. 14-17 in San Francisco.

About Arizona Breast Cancer Specialists

Arizona Breast Cancer Specialists, based in Scottsdale, Ariz., is the first radiation practice in the world exclusively dedicated to treating women with breast cancer. The equipment, devices, and treatment techniques used at Arizona Breast Cancer Specialists have been selected for the ability to maximize precision and effectiveness while minimizing the collateral damage to healthy tissues. For more information, visit