Breast Cancer: Device Aims to Prevent Repeated Surgery

06/27/2013

To reduce the need for subsequent surgeries after removal of a breast tumor, Johns Hopkins graduate students have designed a device to allow pathologists to quickly inspect excised breast tissue within 20 minutes.

If this inspection indicates that the tumor was not fully removed, additional tissue can then be removed during the same operation. Eliminating the need for a second operation could also curb some of the additional anxiety these patients face. The device is still in its prototype stage, but the students say their goal is to give breast cancer patients the same rapid review that commonly occurs when tumors are removed from elsewhere in the body.

"We spoke to breast cancer surgeons," said Hector Neira, one of the student inventors. "They told us that they are desperate for something that will allow them to remove the tumor in its entirety the first time, so that the patient does not have to come back for a second surgery." So far, the team's system has been tested on animal tissue and human breast samples from a tissue bank, but it has not yet been used on patients. Although financial support and recognition the students receive is helpful, "that is not our ultimate goal," said Anjana Sinha, another one of the inventors. "We are not doing it for the money. We want to improve healthcare practices and raise the standard of care for these breast cancer patients. Why cannot they get the same type of quick results that people with other types of cancer receive?"

When most tumors, such as those in the liver, are removed, the pathology staff can quickly flash-freeze the tissue and slice off paper-thin samples for microscopic examination. If the pathologist sees that cancer cells extend to the outer edge or margin of a sample, the surgeon is advised to remove more tissue from the patient. But breast tissue poses a problem: it possesses a high fat content and does not freeze well, causing the samples to smear, form gaps and become unsuitable for a quick review. Instead, breast tissue must be preserved and analyzed in a more time-consuming process that requires the patient to return to the operating room if the first surgery appears to have left cancer cells behind.

To solve this problem, the graduate students brainstormed for an engineering solution. Their most promising and practical idea was a device that applies an adhesive film to the breast tissue before it is sliced. The film holds the delicate tissue together, preventing damage to the samples during the slicing process. The result, the students said, is a sample that can be clearly reviewed by a pathologist within 20 minutes of its removal, potentially eliminating the need for a second operation on another day. The low-cost system includes a reusable applicator and a proprietary disposable film. The students said the need for their product is significant, citing the estimated 330,000 lumpectomies that are performed annually in the United States alone.

"I think the students have been incredibly creative in their development of this concept, and they are addressing a very real need in the field of breast cancer surgery," said Melissa Camp, a Johns Hopkins assistant professor of surgery who worked with the team. "Accurate assessment of margin status during the initial operation will lead to fewer re-operations, and this will be beneficial for patients in many respects. I look forward to their continued work!"

COMPAMED.de; Source: John Hopkins University