Dartmouth doctors, engineers find breast cancer surgery breakthrough

In In The News by Barbara Jacoby

Thumbnail for 5347By MEGHAN PIERCE
Union Leader Correspondent

A new technique of combining MRI and optical scanning can accurately locate small breast cancer tumors during surgery, according to new findings from physicians at the Dartmouth-Hitchcock Norris Cotton Cancer Center and engineers from Dartmouth College’s Thayer School of Engineering.

Together the physicians and engineers developed a new approach to breast-conserving surgery that simplifies the procedure for women whose breast cancer is too small to be felt.

“Conceptually it is similar to a car’s GPS,” the Norris Cotton Cancer Center said in a news release. “The uploaded maps would be the MRI, and the optical scan provides the ‘you are here’ arrow for the surgeon. This more accurate picture of the tumor location and its edges allows for a more precise surgical excision.”

“Supine Breast MRI and 3D Optical Scanning: A Novel Approach to Improve Tumor Localization for Breast Conserving Surgery,” was recently published in the Annals of Surgical Oncology.

“We have developed a technique that gives the surgeon, at the time of surgery, a 3-D picture of where the cancer is in the breast using MRI,” said Dr. Richard J. Barth Jr., section chief of general surgery at Dartmouth-Hitchcock Medical Center. “This is the first time that optical scanning and MRI have been combined to localize breast cancer.”The current way these small tumors are located before surgery is through a separate procedure, which can be uncomfortable for the patient and is not very accurate, according to the news release. About 30 to 40 percent of the time cancer cells are left behind, the news release states, leading to additional surgery to remove the remaining cancer. In this pre-surgery procedure, a wire is inserted into the breast before surgery to mark these small tumors. Barth, an associate professor of surgery at Dartmouth’s Geisel School of Medicine, said the new method of locating breast tumors uses a pre-operative MRI as a map of the tumor and an optical scan to identify the tumor’s size, shape and location.

Together the MRI and optical scan create an interactive 3-D image on a computer screen.

Up next, Barth plans to initiate a randomized prospective study of patients with non-palpable breast cancer to test how the new method compares to the old wire localization method.