The following is Dr. Whitworth’s excerpt from The SAVI SCOUT® white paper, entitled Beyond Wires: Overcoming the Challenges of Breast Tumor Localization published in ONCOLOGY CENTRAL. Currently, Dr. Whitworth primarily uses Intra-operative Ultrasound for tumor localization.
In what ways does using Intra-operative Ultrasound (IOUS) help overcome the challenges that you experienced with tumor localization?
For many years, we have advocated using Intra-Operative Ultrasound (IOUS) to guide our dissection and surgery; with IOUS you can get much better guidance than just guessing where the wire is and trying to dissect down to it. Studies show that the better guidance the surgeon has, the less volume of tissue you take out. With wires, you don’t really get any tactile feedback about where the tumor is in the breast. Even with IOUS, it’s helpful to have some additional guidance; for certain lesions, I use a long, 18-gauge needle placed under ultrasound guidance to get some tactile feedback.
What has your experience been like with the SAVI SCOUT® Surgical Guidance System?
I use IOUS to place the marker in the OR prior to the lumpectomy procedure. IOUS guidance is cumbersome compared to using SCOUT -with IOUS, you have to remove your retractor, turn the lights down, stop to get a look, put the ultrasound probe down, put your retractor back in place. With SCOUT, everything is retracted and held in place. I can be ready to make the next cut through the tissue, grab the handpiece and make the cut more precisely in reference to the target. I find this to be more precise in reference to the target with the immediate real-time feedback as to where your target is as you are cutting through the tissue. This adds to my confidence tremendously because IOUS can be a little hard to interpret as you are going through a complex specimen and the lesion is not that easy to see to begin with.