Making breast cancer surgery more precise
UC Irvine Health is the first in U.S. to use MarginProbe in lumpectomies
May 31, 2013
Any breast cancer surgeon who regularly performs lumpectomies confronts the question “Did I get it all?” Thirty to 60 percent of the time in the United States, the answer is “no,” and the patient must undergo a second surgery to remove the remaining tumor.
UC Irvine Health surgeons are the first in the nation to use a device that reduces by half the need to remove breast cancer cells missed during an initial lumpectomy. The MarginProbe® system lets the surgeon immediately assess whether cancer cells remain on the margins of excised tissue. Currently, patients have to wait days for the results of a pathology test.
“All of my patients know someone who has had to go back into surgery because their doctor didn’t get the entire tumor out,” said UC Irvine Health surgical oncologist Dr. Alice Police. “The ability to check tissue in the operating room is a game changer in surgery for early-stage breast cancer.”
The goal in a lumpectomy is to completely remove the cancer while preserving as much normal breast tissue as possible. If a pathologist finds cancer cells on the edges of the tissue taken out, surgeons must assume the lumpectomy didn’t get the entire tumor.
The Food & Drug Administration approved MarginProbe in December, and UC Irvine Medical Center is the first hospital in the U.S. to employ the system, according to manufacturer Dune Medical Devices.
Police, assistant professor of surgery at UC Irvine and medical director of Pacific Breast Care in Costa Mesa, and Dr. Karen Todd Lane, associate professor of surgery and clinical director of the UC Irvine Health Breast Health Center in Orange, began operating with MarginProbe in early March.
They had participated in an FDA trial that included more than 660 women across the United States. In the prospective, multiple center, randomized, double-arm study, surgeons applied the device to breast tissue removed during in-progress initial lumpectomies and, if indicated, shaved additional tissue on the spot. This was found to reduce by 56 percent the need for repeat surgeries.
“It will save you a lot of anxiety,” said Jane Madigan, a Costa Mesa resident who underwent the procedure with Police as part of the MarginProbe trial. “You will come out of that surgery knowing you are cancer-free.”
The system comprises a sterile handheld probe and a portable console. When the probe tip touches an excised lumpectomy specimen, radio-frequency signals are transmitted into the tissue and reflected back to the console, where they are analyzed using a specialized algorithm to determine tissue status.
— John Murray, UC Irvine Health
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UC Irvine Health comprises the clinical, medical education and research enterprises of the University of California, Irvine. Patients can access UC Irvine Health at physician offices throughout Orange County and at its main campus, UC Irvine Medical Center in Orange, Calif., a 412-bed acute care hospital that provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation. U.S. News & World Report has listed it among America’s Best Hospitals for 12 consecutive years. UC Irvine Medical Center is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program, Level I trauma center and Level II pediatric trauma center, and is the primary teaching hospital for UC Irvine Health School of Medicine. UC Irvine Health serves a region of more than 3 million people in Orange County, western Riverside County and southeast Los Angeles County.