Surgery to have a breast lump removed or to biopsy breast tissue is something women dread. So imagine how patients feel when they are told that, on the day of surgery, they will have to have TWO procedures — not one. Previously, that was the case, but now a new technology is making it easier. It’s a new micro-impulse radar tissue localization tool that can be implanted up to 30 days prior to surgery, putting less stress on the patient, and making surgeries easier to schedule for all involved. It’s called the SAVI scout.
“The patient can check into surgery without having to go for an additional procedure that morning,” says Jane Porretta, M.D., a surgeon with University of Utah Health Care. “The implantation is much less stressful because it isn’t done on a day when the patient is coming in with an empty stomach, and nervous about surgery.”
How the SAVI SCOUT differs
The most common tissue localization procedure has to be done on the day of surgery because it involves a wire being inserted into the breast — which remains sticking out of the breast until the surgery is completed. Known as wire localization, the procedure is done by a radiologist using a mammogram or ultrasound machine to insert the wire as close to the abnormal tissue as possible. The surgeon then follows the wire down to the tissue and removes it. This means the surgeon and radiologist must coordinate their schedules, along with the schedule of the patient.
With the SAVI scout, not only is the patient spared the discomfort of having to sit with a wire sticking out of her breast, but scheduling is made easier since both procedures are done independently. “It gives more flexibility for us and the patient,” says Anna McGow, M.D., M.B.A., a radiologist with University of Utah Health Care. “We don’t have to worry about so much coordination.”
There is another tissue localization method that can be done outside of the day of surgery, but it comes with its own set of issues. That method involves a small seed…that is radioactive. This means the patient, and people in close physical contact with them, are exposed to small amounts of radioactivity. It is recommended that anyone who has one of these seeds implanted avoid placing small children or infants on their chests for more than 30 minutes a day until the seed is removed.
There is also the matter of properly disposing of the seed after surgery. “There are very specific regulations when it comes to handling and disposing of these seeds,” says Porretta.
Radioactive vs. reflective
The new localization method is not radioactive but instead is reflective. The seed is placed in the center of the abnormal tissue by a radiologist using ultrasound or mammogram technology. Once it is placed, mammogram scans are taken for the surgeon’s reference and marked with the relation of the mass to the nipple and other parts of the breast. In surgery the surgeon will locate the reflector not only using these scans, but a probe that emits infrared light, an electromagnetic field, and detectors to pick up signals coming from the seed. “It allows me to be a more accurate in the tissue I remove instead of tracing a wire down,” says Porretta. “I have a better exact localization, so I can take less tissue.”
After the tissue is taken out, it is sent back to the radiologist who examines it and compares it the mammogram scans taken earlier and makes sure the seed is out as well. “The seed is really tiny physically, but we can see it on an ultrasound or mammogram,” says McGow. “Once we have confirmed everything was taken out that needed to be we notify the surgeon and they can end the surgery.”
The new technology is giving more scheduling flexibility, improved surgical experiences, and improved outcomes at a time when an increasing number of women have to have breast localization procedures. Some reports say the number of these procedures performed every year could double by the year 2020. “If that is true the advantages of this new technology will be invaluable,” says Porretta.