Does the Mammography Debate Miss a Key Point?

Every time the US Preventive Services Task Force issues a recommendation about when women should start getting mammograms – and how often they should have these screenings – it sends shockwaves through the breast-cancer world.

modiglianiThis last time was no different.

But now two influential breast cancer experts assert that – as important as the debate is – it misses an essential point about evaluating a woman’s individual risk of getting breast cancer.

Those experts – Dallas breast surgeon Dr. Peter Beitsch and Nashville breast surgeon Dr. Pat Whitworth – say the key question is how to evaluate “risk.”

The latest recommendations from the task force call for women at “average risk for breast cancer” to begin every-other-year screening at age 50. It casts doubt on the true value of screening beginning at age 40 – citing the high number of false-positive test results in women 40 to 50, plus potential harm from overdiagnosis and unnecessary treatment. Continue reading “Does the Mammography Debate Miss a Key Point?”

IORT with Oncoplastic Surgery: A Beautiful Combination?

Julie Reiland SOS 2016 (1)
Julie Reiland, MD, FACS

Breast cancer care continues to see remarkable growth in knowledge of the disease and advances in treatment. That was certainly evident at the recent School of Oncoplastic Surgery (SOS), in Dallas last month.

The school, which was founded by breast surgeon Gail Lebovic, M.D. with a grant from the Mary Kay Ash Foundation, recently had its eighth annual session in Dallas. This year’s session was sponsored by the National Consortium of Breast Centers and the American Society of Breast Disease Clinical Track.

Among the highlights of that three-day training workshop was a talk by Julie Reiland, MD, FACS. An SOS faculty member, Dr. Reiland is a breast surgeon at Avera Medical Group Comprehensive Breast Care, in Sioux Falls, SD. Speaking to a packed room at SOS, Dr. Reiland talked about the convergence of oncoplastic surgery and intraoperative radiation therapy (IORT).

In particular she talked about Continue reading “IORT with Oncoplastic Surgery: A Beautiful Combination?”

Brighter Days for Ambulatory Surgery Centers with Innovative Breast Care

Ambulatory surgery centers face plenty of financial (some might even say “existential”) challenges. Among these are a tightening reimbursement environment, competition from hospital systems, and high health insurance deductibles.

Cross in OR - XL-2
Dr. Michael Cross is establishing an international reputation for innovations in breast cancer surgery.

Nonetheless, breast cancer care is emerging as a bright spot for ASCs, including two centers we talked with recently.

In a large New York City surgery center, for example, breast care helps lead the way. In an Arkansas center, transparent pricing and use of a relatively new surgical marker called BioZorb are part of the story.

First, though, let’s talk about those challenges.

“The changes in healthcare have been accelerated with passage of the 2010 Affordable Care Act, a.k.a. Obamacare, the expansion of Medicaid programs, an economy that is improving at a slower than normal rate, and stagnant increases in wages,” Laura Dyrda wrote recently in Becker’s ASC Review, “Reimbursement is in flux for many surgical specialties,” and high-deductible Continue reading “Brighter Days for Ambulatory Surgery Centers with Innovative Breast Care”

School of Oncoplastic Surgery Shows the Way to Better Breast Cancer Care

Dr. Gail Lebovic
Dr. Gail Lebovic founded the School of Oncoplastic Surgery

Among the many improvements in the care of women who have breast cancer, one of the most promising is oncoplastic surgery.

This approach combines methods to remove cancer with reconstructive techniques to insure complete tumor control. At same time it achieves better aesthetic outcomes.

This month’s upcoming School of Oncoplastic Surgery will help surgeons develop new skills they can use when performing breast-conserving surgery (lumpectomy) on patients with breast cancer. The three-day course will be held Jan. 22-24, 2016 in Dallas.

The 2016 version of the school is sponsored by the National Consortium of Breast Centers, the Senologic International Society, and the Postgraduate Institute for Medicine.

The course provides a spectrum of skills for attendees. Through a sculpture lab, anatomy lab and interaction with live models, surgeons learn essential tools with hands-on experiences. Panel discussions and case presentations also allow surgeons to openly discuss challenges they face in their practices, and to learn various ways to address complex clinical situations in cancer care.

The founder and leader of the school is Dr. Gail Lebovic. She’s a past president of the American Society of Breast Disease, recipient of several distinguished awards and the inventor of multiple successful medical technologies in women’s healthcare.

Continue reading “School of Oncoplastic Surgery Shows the Way to Better Breast Cancer Care”

ASCO Meeting Features First Independent Comparison of Breast Cancer Genomic Tests

The combined MammaPrint and BluePrint genomic tests provide more information about the specifics of breast cancer than does the older, 21-gene test, according to the first independent assessment comparing the assays. That study was among the major new findings about breast cancer molecular diagnostics – also called genomic tests – emerging from this year’s recent annual meeting of the American Society of Clinical Oncology (ASCO).

Brufsky for DD blogAlso featured at ASCO were new insights about breast cancer in African-American women, drawn from research with MammaPrint and BluePrint conducted in the nation’s capital.

Together, the 70-gene MammaPrint and 80-gene BluePrint tests definitively categorize patients as Low Risk or High Risk for breast cancer recurrence and provide additional information about the specific biology of the cancer. The older and less sophisticated 21-gene test, on the other hand, stratifies patients into three risk-recurrence categories: Low Risk, High Risk, and Intermediate. Continue reading “ASCO Meeting Features First Independent Comparison of Breast Cancer Genomic Tests”

Novel 3-D Marker Is ‘Game Changer’ for Post-Surgical Radiation Therapy

When most of the business news is about big companies, it’s easy to forgeGreen glove with BZt that there’s still room for a little guy with a great idea. Medical device maker Focal Therapeutics is clearly one of the latter, as a new scientific presentation underlines. The presentation was given at the 2014 Breast Cancer Coordinated Care (BC3) conference, held in February in Washington D.C.

Focal Therapeutics developed the BioZorb™ three-dimensional surgical marker, to help identify the surgical excision site following soft tissue removal, such as breast lumpectomy cavities.  The marker makes it possible for physicians to visualize the surgical region post-surgery. This helps to improve clinical precision for post-operative treatments and follow-up.

To understand the difference this makes, consider a woman who has just had a lumpectomy and now needs post-surgical radiation to prevent her cancer from returning. Once this 3D marker is placed by her surgeon, her radiation oncologist can locate the exact site more precisely, clinicians can better target the radiation (thereby decreasing the volume of tissue that receives radiation minimizing radiation exposure to nearby healthy areas such as the heart and lungs.

The presentation showed BioZorb as an alternative to traditional tissue landmarks such as seroma and clips as well as post-operative density changes seen on CT scans done for treatment planning. The results were dramatic. The device enabled physicians to achieve a greater-than-50% percent reduction in planned treatment volume, according to poster co-author Robert R. Kuske, Jr., M.D. Dr. Kuske is an internationally known radiation oncologist who uses BioZorb in his medical practice at Arizona Breast Cancer Specialists.

What’s more, there appeared to be no downside to using the BioZorb marker. Patients tolerated placement of the device without complications, and cosmetic outcomes were excellent.

With traditional methods, treatment planners have to do a certain amount of guesswork and treat a bigger area because the borders of the area needing treatment aren’t obvious. That can mean a higher radiation dose, more risk to healthy tissue and organs, and negative impacts on the patient’s appearance.

Co-author Linda Smith, M.D. of Comprehensive Breast Care in Albuquerque, N.M. said “It was a revelation to see the surgical edges so clearly with the BioZorb device in place.” Read more about the presentation here.

Dr. Gail Lebovic
Dr. Gail Lebovic

BioZorb’s inventors appear to be true visionaries, because there’s no other device like theirs in the medical marketplace. Unlike other markers, BioZorb defines the treatment area in three dimensions. Its unique open spiral is made of a bioabsorbable material, which means the patient’s body absorbs it slowly over time. That makes surgical removal after completion of therapy unnecessary.

Dowling & Dennis has worked with Focal Therapeutics’ George Hermann, president and CEO, Gail Lebovic, M.A., M.D., FACS, the company’s chief medical officer, as they have created several innovative devices in breasthealth. From all appearances, BioZorb is extending their career-long hot streak.