PSP Breast Cancer Series, Part 2: Dr M. Michele Blackwood of RWJBarnabas Health shares why she converted to the wire-free device; plus 5 tips for oncoplastic surgeons heading to the OR.
There’s a tremendous amount of work that goes into preparing a breast cancer patient for an oncoplastic surgical procedure. According to M. Michele Blackwood, MD, chief of section breast surgery at Rutgers Cancer Institute of New Jersey and professor of surgery at Rutgers Robert Wood Johnson Medical School, it’s likely that a breast cancer patient will have interacted with more than 20 healthcare professionals on staff before they even make it into the operating room (OR).
A patient must meet with the office staff, surgical scheduler, radiology department, physician’s assistant, and plastic surgeon, among others, she explains. The patient will also complete a preoperative health clearance, COVID-19 testing, and health insurance validation. “There’s lot of patient education and patient communication involved in this process,” says Blackwood, who is also the medical director at The Center for Breast Health and Disease Management at the Barnabas Health Ambulatory Care Center, “So it’s important for the entire medical team to be on the same page because you don’t want anyone to confuse the patient. For example, if the plastic surgeon has promised the patient a lumpectomy and a breast lift simultaneously, as a breast surgeon, I may re-evaluate and recommend that there is not enough tissue left to follow through because there are too many tumors to save the breast.”
Blackwood, who has practiced breast surgery for the past 35 years, says many people think breast cancer is one disease with only one treatment. But, there are multiple subtypes within breast cancer, she says, and multiple types of treatments available. Some patients are given at-home medication; some undergo a short lumpectomy procedure; others will need to pursue a full mastectomy combined with chemotherapy and radiation treatments. No matter what the results show, she doesn’t want patients to be afraid because “it’s never a one size fits all” remedy.
One of the latest devices being used to identify cancerous lesions and improve surgical outcomes is the Hologic LOCalizer™. Blackwood converted over to the wire-free guidance system about 14 months ago. This technology was built to mark and guide to non-palpable breast lesions using a miniature radiofrequency identification (RFID) Tag.
“The Hologic LOCalizer™ has been a real game changer for us,” says Blackwood. “We’ve trialed at least three different products over the years for the localization of breast tumors during lumpectomy procedures, and it can be incredibly stressful if a device malfunctions in the OR. The LOCalizer™ is consistent and you can count on it. It’s a secure product compared to the ones we’ve previously used.”
Review a Lumpectomy Case
Tech Demo: LOCalizer®
Another prime benefit is the product’s flexibility, which enables doctors to place the LOCalizer in any time before scheduled chemotherapy or surgery dates. If there is more than one tumor to be removed from the breast, the wire-free technology pinpoints exactly which piece of tissue the doctor should remove. “That’s very reassuring when you’re in the OR,” says Blackwood, “because you want your surgeries to be precise and in tune with the patient’s health needs.” In addition to reducing stress levels in doctors and their patients, Blackwood notes that implementing this wire-free technology has positively contributed to a more seamless interaction that is necessary to prepare doctors and their patients for oncoplastic surgery in the OR. “That’s huge, and it helps our patients tremendously!”
If you’re teaming up with a breast surgeon and medical oncology staff to perform an oncoplastic surgery procedure, consider the following 5 tips from Blackwood and Valerie Gorman, MD, FACS, chief of surgery and medical director of surgical services at the Baylor Scott and White Waxahachie, Texas Surgical Specialists/Texas Breast Center.
5 Tips for Successful Oncoplastic Surgery Outcomes
- Educate your patient. It’s difficult for a patient to become an expert in breast cancer care when they’re facing their own diagnosis. Provide your patient with as many healthcare and community resources available to them as you are aware of, so they can make an informed decision.
- Listen to what’s important to the patient, but don’t make aesthetic reconstructive promises you can’t keep. Removing the cancer is the most important part of the operation. Breast surgeons and plastic and reconstructive surgeons must be on the same page. Based on the resources (breast tissue) available, communicate clearly with everyone involved about what type of surgery you’re doing. It’s important to work together with the entire medical team to meet your patient’s goals.
- Encourage your patient to get their family involved. It’s very important for a patient’s spouse, loved one, or caregiver to understand the process and be on the same page as well.
- Keep in touch with your patient. A breast cancer diagnosis can cause fear and anxiety in many patients, and they spend a lot of time waiting. They wait for test results, and they wait for surgery. Providing an open line of constant communication will comfort, support, and encourage them throughout the entire breast cancer treatment process.
- Be flexible and understanding. Help your patient create an individualized plan of action for treatment care that fits into their lifestyle. If they are experiencing life challenges that are preventing them from keeping appointments, be willing to help.
Tonya Johnson is associate editor of Plastic Surgery Practice
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