Posted by: bcconnections | September 20, 2012

New device could lower re-excision rates for women undergoing lumpectomy

Breast conserving surgery, or lumpectomy, is performed in 60-75% of women diagnosed with breast cancer (McCahill, JAMA.2012;307(5):467-75).  After the surgeon removes breast tissue during a lumpectomy, a pathologist analyzes the tissue to ensure that it has “negative margins,” or that the edge of the tissue does not contain cancer cells.   If the edge of the tissue does contain cancer cells, then the sample is said to have “positive margins” and additional surgery, or “re-excision” is often required to remove any remaining cancerous tissue.  It is estimated that 20-40% of women who have lumpectomies require re-excision in order to achieve negative margins.  The need for re-excision has several negative consequences, including increased stress for the patient, a possible delay in post-surgical therapies like chemotherapy or radiation, and a possible inferior cosmetic result.

According to Dr. Susan Boolbol, who presented at the 2012 Breast Cancer Symposium, a new device called the MarginProbe (Dune Medical Devices, Inc.) reduces the number of re-excisions without the need to take more breast tissue. The MarginProbe device capitalizes on the differences between the electrical properties of normal cells and cancerous cells to identify breast cancer cells on the surface of excised breast tissue.  Researchers enrolled 596 women undergoing lumpectomy in a clinical trial and randomized them to a control group or a device group.  Among women with ductal carcinoma in situ (DCIS) alone, use of the MarginProbe reduced the rate of re-excision from 37% to 13%.  Similarly, among women with DCIS and invasive breast cancer, use of the device reduced the rate of re-excision from 33% to 17%.  The amount of excised tissue required to achieve negative margins was similar in both the control group and the device group.



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