Researchers have made a significant breakthrough in the field of breast tumour localisation.
The University of Cincinnati Cancer Center team found that a GPS-like seed device is safe and effective for aiding surgeons in precisely locating and removing breast and lymph node tumours.
The study, which assessed the use of SmartClip devices, marks a potential game-changer in how breast cancer surgeries are conducted.
For decades, wire localisation has been the conventional method for guiding surgeons to non-palpable breast lesions.
However, this technique has disadvantages, including scheduling constraints and complications such as vasovagal reactions during placement, wire migration and transection.
Modern implantable markers, such as SmartClip, have been developed to streamline the localisation process in response to these issues.
These markers can improve the efficiency and comfort of patients undergoing breast tumour excisions.
The research, recently published in The American Surgeon, outlines the findings of a feasibility study conducted by the University of Cincinnati Cancer Center.
The study reviewed 100 consecutive patients who underwent breast and axillary procedures in 2021 using SmartClip localised markers.
The results were promising, highlighting the safety and efficacy of this novel technique.
The study revealed that the localised breast lesion or lymph node was successfully excised in all cases, and SmartClip was retrieved, as confirmed by intraoperative specimen radiographs.
Notably, 45.1% of the cases involved malignancy, as determined pre-operatively, with 18.2% requiring re-excision due to positive margins. Sometimes, two or three SmartClips were placed per case for bracketed or multiple lesions.
Dr Jaime Lewis, a cancer centre physician-researcher and associate professor of surgery at the UC College of Medicine, played a pivotal role in testing and implementing SmartClip devices.
She explained that SmartClips improved efficiency and safety compared to the traditional needle and wire technique, typically performed on the day of surgery and can be uncomfortable for patients.
She added: ‘There’s still some technical glitches with it, but I think that a device like this or another iteration of the future is definitely where we should go. Patients definitely seem to be happier, I think surgeons are happier, radiologists are happier, and it makes the flow of patients through procedures much better. Some improvements could be made, but getting rid of needles and wires will help with a number of those things.’
SmartClips can be implanted at any time before surgery, allowing radiologists to schedule implantation when it is most convenient. This shortens the patients' day of surgery and reduces the risk of cancellation due to complications during localisation, like vasovagal reactions.
According to Dr Lewis, using SmartClips improves the operative schedule and minimises interference with surgeons’ incision choices.
It offers patients the advantage of two shorter visits rather than one long day of surgery, eliminating the discomfort of having a needle and wire protruding from their breasts.
SmartClips are part of a growing array of devices designed to enhance breast tumour localisation, replacing the traditional wire and needle technique.
The move to these innovative devices is a positive development for patients and clinical teams, simplifying procedures and enhances patient experience.
A comprehensive cost-benefit analysis is expected to evaluate the full impact of this revolutionary technique.
