A Look at Innovative Approaches to Cancer Care
Avera Cancer Institute never stops looking for advanced technology to help its patients. Here’s a brief look at some approaches and medical equipment that truly continues the top-quality approach patients expect from Avera.
Contrast-Enhanced Spectral Mammography (CESM): The SenoBright CESM technology in use at Avera Breast Center, Prairie Center, allows multidisciplinary teams to confirm findings – especially in dense breast tissue – and locate lesions or tumors when initial screenings are inconclusive. Avera Medical Group Radiologist Patrick Nelson, MD, said the enhancement that CESM provides makes accurate scans easier, regardless of the patient and her unique physiology.
“We were among the first facilities in the nation to install CESM, and in just a couple of years it has become an integral problem-solving tool for us,” Nelson said. “It really helps in difficult cases, in situations where we have a positive lymph node test but where standard mammography images are inconclusive. It’s an irreplaceable part of our practice now – especially in complicated cases.”
Nelson added that CESM is less expensive and faster than MRI.
Savi Scout: Locating a breast tumor, in the past, could include the use of guidewires to assist the surgeon, or in some cases, the use of a radioactive marker. Savi Scout is a non-radioactive alternative that helps improve efficiency and accuracy. Julie Reiland, MD, breast surgeon, said the device is a distinct improvement from past methods.
“We were among the early adopters of this technology and it allows us to put a reflective electro-magnetic marker in place prior to surgery and in doing so, we avoid any issues that go with a radioactive marker and the discomfort and difficulties that went with guide wires,” she said. “It makes our work easier and more accurate.”
PEAK Plasma Blade: Radiofrequency energy allows a surgeon using this device to cut and control bleeding, all at one time. Reiland said the precision it provides gives breast surgeons an advantage. “It controls bleeding with less heat, thus avoiding the char that may come with older electro-surgical methods,” Reiland said. “It reduces tissue damage as well as time in the operating room,” The electrode the PEAK Plasma Blade employs is less wide than a human hair; it also allows incisions to heal more rapidly.
Electron-based intraoperative radiation therapy (IORT): This technology offers a concentrated dose of radiation to the tumor bed, in the operating room, at the time of lumpectomy – surgery to remove the breast cancer but preserve the rest of the breast. Radiation is typically given one month after lumpectomy to reduce the risk of cancer recurrence in the breast. It usually involves daily treatment for six weeks.
IORT is part of an international clinical trial at Avera.
Reiland explained that IORT offers simplicity in terms of radiation treatment. “We know we are getting the radiation to the right area and in a timely fashion.” For women age 60 and older with less-aggressive cancers, it can be a one-time treatment and eliminate the need for any other radiation treatment. For younger women, a partial dose of radiation is given in the operating room and that reduces the number of follow-up radiation treatments down from six weeks to three weeks. Radiation after lumpectomy serves to reduce the risk of recurrence at the same site.
Avera Cancer Institute was the first facility in the nation to put this treatment to use for breast cancer patients through the international trial. Reiland said this approach can reduce radiation damage to healthy tissue and in many cases help patients avoid return trips to have additional follow-up radiation therapy.
Breast Reconstruction: Avera Medical Group Plastic Surgeons Barry Martin, MD, and Mark Shashikant, MD, recently began their practice in Sioux Falls, and the experienced duo offers their skills to augment the surgical services of the Avera Cancer Institute. Surgeons from both groups collaborate to help all women consider their approaches.
Martin said there are advantages to completing reconstruction during the initial surgery for lumpectomy or mastectomy, but that each case is unique. “Each time, we match the operation to the patient, especially in terms of their health,” he said. “In many cases they may need additional treatment post-surgery, and then reconstruction can be considered and planned.”
Avera Medical Group Plastic & Reconstructive Surgery now features Vectra XT 3-D Imaging technology. The system can help women who are considering reconstruction have clear, understandable information about the possibilities of reconstruction. The clinic is the only one in the region to offer the leading-edge imaging technology.