A local surgeon is among the first in California to combine innovative techniques and new technology to improve the treatment of breast cancer.
Dr. Anne G. W. Peled, M.D., surgeon at Sutter Health’s California Pacific Medical Center (CPMC) is using an approach called oncoplastic surgery and a tiny new implant, called BioZorb, to provide better cosmetic outcomes after surgery and allow more precise targeting of radiation treatment.
Dr. Peled, a breast oncologic surgeon and board-certified plastic surgeon with the CPMC breast cancer program, has helped pioneer use of the BioZorb marker.
The three-dimensional device is placed during lumpectomy surgery, which removes the cancer and preserves the breast.
This approach facilitates oncoplastic techniques, which involve rearrangement of the patient’s own breast tissue to provide both cancer control and more aesthetically pleasing results.
“There are several ways BioZorb really helps our breast cancer patients,” Dr. Peled says. “Using this device provides a framework to help reshape the breast after surgery. It also allows the radiation oncologist to more precisely target radiation therapy. Longer term, it makes it easier to track the site of tumor removal on follow-up mammograms.”
Susan Yeres, 62, is among Dr. Peled’s patients whose treatment included use of the marker. A San Rafael resident, Yeres is an independent consultant in the juvenile and criminal justice system.
She was found to have a small tumor in each breast. In consultation with Dr. Peled, she decided to have a breast reduction and lumpectomy in both breasts.
“Given that I had a breast reduction, the marker increased the ability to locate the original cancer site. It allowed me to have more extensive surgery and still have the original spot of the cancer easily identified,” she says. “I also feel good about the cosmetic outcome of the process. Having one surgeon do both the plastic surgery and oncological surgery was a winning idea for me.”
Yeres noted that the marker fit well with her shorter course of follow-up radiation. “It was wonderful to be able to reduce the number of scans thanks to the marker,” she says. “It made the last portion of the treatment very easy.” Yeres had a quick recovery from treatment and was able to go on vacation shortly afterward.
Among the radiation oncologists noting the benefit of using the BioZorb at CPMC is Dr. John W. Lee.
He said the marker allowed him in most cases to narrow the radiation field to limit exposure to healthy tissue and surrounding organs such as the heart and lung. “The benefits to the patient with the marker are, first, they get better targeting because we know exactly where the tumor was; and second, fewer side effects because we don’t have to treat such a large area of the breast,” Dr. Lee says.
BioZorb is the first device that identifies in a fixed, three-dimensional manner where the tumor was removed. The implantable device consists of a framework made of a bioabsorbable material that holds six titanium clips. The framework slowly dissolves as cells grow into the tumor cavity over the course of a year or more. The tiny marker clips stay in place so the surgical site can be viewed for long-term monitoring such as future mammograms.
Where do these new approaches fit with other trends in breast cancer treatment?
“Most of our patients are now wonderfully lucky to have their cancers detected early and to live a long time after their treatment,” Dr. Peled says. “After treatment they really want to have breasts that they are happy with and to feel like they are getting the right treatment that’s tailored for them.”
“I love being able to offer this marker as a possibility for my patients,” Peled adds “It lets them know I’m thinking about how to achieve the best outcome and gives them a great feeling about participating in something that’s going to advance the way we treat breast cancer.”