Andrea “Andy” Noll is pleased she was sent to a young surgeon when she was diagnosed with breast cancer.
The 64-year old kindergarten teacher knows medical care is ever-changing and she wanted the latest treatment options. She knew right away that Dr. Troy Shell, a breast surgeon affiliated with Physicians Regional Healthcare System, is current in her field.
“She’s a young doctor up on all the latest technology,” Noll said.
Shell came to Southwest Florida in 2015 knowing there is a better way to locate tumors than a wire inserted in the breast. Another option is radioactive seeds but there are regulatory issues with seeds.
“I wanted to make sure we had an alternative to wire localization,” Shell said. “It is very archaic with lots of negatives. The wire is six to 10 inches hanging out of the breast.”
At the 2015 annual meeting of the American Society of Breast Surgeons in Orlando, Shell attended a program about a new surgical guidance system called SAVI Scout for breast tumor location.
“I became very excited about it,” Shell said.
This past spring, she evaluated the SAVI Scout system for patients at Physicians Regional. The hospital purchased it in August.
Each year, about 220,000 cases of breast cancer are diagnosed in women and about 2,000 cases are in men, according to the Centers for Disease Control and Prevention. About 40,000 women and 400 men die annually from it, according to the CDC.
Marketed by Cianna Medical, Inc. out of Aliso Viejo, California, the SAVI Scout system uses electromagnetic wave technology in two pieces; a reflector that is implanted at the tissue location and a wand which the surgeon uses to know exactly where the tumor is located.
“It’s a little bigger than a grain of rice,” Shell said about the size of the reflector implanted at the tumor.
What’s also advantageous besides reducing patient anxiety is being able to more precisely target a tumor. It’s also easier to remove cancerous tissue around the reflector compared to the wire, she said.
“And that usually means better cosmetic outcomes,” she said.
Dr. Charles Cox, a breast surgeon at the University of South Florida in Tampa, conducted a pilot study at USF to evaluate its safety and efficacy.
“(It) allows the surgeon to identify the perimeter of the lesion and be able to carefully localize the lesion and remove it accurately,” Cox said in an email.
Shell said patients prefer the reflector, implanted with a needle using imaging guidance, as opposed to the wire. The wire means
arriving earlier the day of surgery to have it put in. The reflector device can be implanted up to 30 days in advance of surgery.
The reflector cannot be lost in the tumor because of the wand the surgeon uses to pick up the electromagnetic waves as guidance to the correct spot.
Noll became one of Shell’s first patients locally to have the reflector instead of the wire. Although the area was numbed, there was some discomfort when it was put in. Still, she favored that over a wire.
“This is like the GPS for a tumor,” Noll said. “She didn’t have to take as much tissue out.”
Noll believes the technology was a factor for a smaller scar, and many people wouldn’t realize she had a lumpectomy after the cancer was found in her left breast. She also had seven weeks of radiation treatment.
“I just went back for a re-check and they gave me a thumbs up,” Noll said.
Shell said there are patients for whom the SAVI Scout cannot be used, namely patients with multiple tumors or very large breasted women. Shell has used the SAVI Scout with about 20 patients so far.
“We do take into consideration the density of the breast,” Shell said.
Another surgeon involved in clinical evaluation of the system, Dr. Pat Whitworth at Nashville Breast Center, presented findings at another surgeons’ meeting that involved 154 patients and there was a 100 percent success rate, and lower repeat surgery rates, according to a paper published by the manufacturer.
Sixty hospitals nationwide have adopted the SAVI Scout system, of which 18 are in Florida, according to the manufacturer.