In her effort to reduce unnecessary surgery, Dr. Wachsmuth has added another tool to her armamentarium in the fight against breast cancer: MarginProbe®. "Whether we're talking about sentinel lymph node biopsy versus axillary dissection or lumpectomy versus mastectomy, the trend is to minimize the amount of surgery, and I feel that MarginProbe helps to accomplish that. I hate to take a patient back to the OR. But in the past, I had to do large lumpectomies to help ensure that I did not have positive margins since that would necessitate additional surgeries. With MarginProbe, I take more margins than I would have previously. Yet, I'm starting out with a much smaller lumpectomy, as the probe allows me to remove less tissue and still ensure that the margins are clear, resulting in a smaller lumpectomy."
MarginProbe Helps Preserve Breast Tissue
"In one of my first cases using MarginProbe, I had a positive margin, and I took additional tissue to prevent the need to go back in later. The specimen looked fine on x-ray and I would not have taken additional tissue without MarginProbe. This is a patient that would have needed to go back to surgery to remove an additional margin."
MarginProbe assists Dr. Wachsmuth in improving cosmetic outcomes beyond reducing the need for extra surgeries. "I'm a big believer in hidden scar procedures, where I place my incisions so they will not be as easily seen. I also believe that when you remove less tissue, you have less contour abnormality and less deformity in the breast. As I move tissue around to strategic locations to try and fill up the breast cavity, MarginProbe has been a big help; the smaller the cavity, the less tissue I need to move around."
Less tissue needs to be taken with MarginProbe due to the tool's precise nature compared with other detection methods, such as an x-ray. "X-ray has always been a very gross evaluation. X-ray may suggest a margin is positive that on pathology isn't even close or, conversely, it may suggest a widely clear margin while the final pathology confirms an involved margin."
Documenting the Reduction in Tissue Removal with MarginProbe
With over 50 cases completed so far Dr. Wachsmuth has very positive initial impressions. "I know that I'm taking much smaller lumpectomies. We evaluated the amount of tissue removed with MarginProbe and the associated re-excision rates. The results of my evaluation conclude a 67% reduction in re-excision rate from 12% to 4% and a 23% reduction in main specimen size."
Why is Dr. Wachsmuth making this effort? "I think we already cure the majority of breast cancer patients. But I also believe that women should not have to look in the mirror and be reminded daily of their fight against breast cancer."