Dr. Toni Storm-Dickerson examines a woman’s bare chest and points to a small mark in operating room 12. Dr. Storm-Dickerson shows where a radiologist inserted a magnet. Storm Dickerson then grabs a probe and pushes it against the woman’s right breast. The machine then beeps as Storm-Dickerson moves the probe. The ping gets louder as the wand hones in on the magnet. Then, it signals when the probe is directly above the magnetic seed, which is placed inside the woman’s breast.
Storm-Dickerson will remove a lesion where the magnet is located, the cancerous cell that resulted in a breast cancer diagnosis. While utilizing the magnet and the probe, the breast surgical oncologist is confident in the location of the lesion.
Storm-Dickerson could not say the same using a previous technique for locating lesions. As Storm-Dickerson and PeaceHealth Southwest Medical Center test three different devices for locating lesions in breast cancer patients, the uncertainty is now a thing of the past. Storm-Dickerson explains, “So far, we’ve done several with magnets,” Storm-Dickerson said. “And we love them.”
For many years, breast cancer was treated with mastectomies. But as technology improved, so too did the idea of breast conservation. Chemotherapy trials provided an alternative to radical surgeries, and advances in imaging allowed for earlier cancer detection. Storm-Dickerson explained the advances, “With all this new imaging, we can identify cancers before they’re palpable.”
However, because lesions are too small to be felt, surgeons needed a way to mark the cancer. Ultrasound devices can’t be used after an incision is made and mammograms only provide two-dimensional images, Storm-Dickerson said. Traditional options for marking non-palpable tumors include wires and radioactive seeds. Although radioactive seeds are effective, they come with a slew of costly regulations, Storm-Dickerson said, while wires are most often used.
For the wires, a radiologist places a wire, 15cm or longer, with a little hook at the end into the lesion in the breast tissue. The other end of the wire remains outside of the body and is taped down to try and prevent the wire from shifting. However, the tape can’t guarantee the wires won’t move. Storm-Dickerson explains, “Breast tissue is extremely mobile.” Storm-Dickerson and radiologists are performing trials of three different devices to find the best fit for the medical providers and patients.
The Magseed was tested first, it is similar to the size of a grain of rice. The trial was so promising, the hospital decided not to go back to using wires. Instead, Mag Seeds were used in between trials of the other two devices. “We just don’t want to go back,” Storm-Dickerson said. The other devices to be tested are Savi Scout and LOCalizer. Both are larger and require larger needles to place than the Mag Seed. Each device will be used on about a dozen patients before a decision is made.
While operating, Storm-Dickerson uses the probe to locate the magnet and, with that information, decides where to make the incision and the surgical oath for removing the tissue. Storm-Dickerson use to have to view the two-dimensional mammogram images to create a model of the breast in her mind and then use wires as a guide to locate and remove the lesion.
Magseed results in quick procedures and since it can be done in advance, it is easier to schedule at the convenience of the patient and radiologist. On the day of the surgery, the patient doesn’t have to worry about the other procedures and periods of sitting and waiting before the lumpectomy. Storm-Dickerson explained, “It’s much quicker, easier, and more efficient. For me, it’s really exciting to be able to take advantage of these things.”