Impact of a Novel Bioabsorbable Implant on Radiation Treatment Planning for Breast Cancer

Lebovic, Gail S.; Ross, Joseph G.; Jones, Scott; Smith, Arnold B.; Harms, Steven E.

doi:10.1007/s00268-016-3711-y

Cited by 13 publications

(11 citation statements)

References 55 publications

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“…In the control group, radiation target volume was determined by pretreatment imaging, surgical clips, and the breast seroma cavity. In the group with the BioZorb device, there was a statistically significant reduction in radiation boost clinical target volume and planning target volume, but not ipsilateral lung or heart radiation, which was measured by median Gy of radiation delivered to these organs . Lastly, Foster et al retrospectively reviewed 116 patients with breast cancer undergoing breast radiation, which compared 42 patients with the BioZorb to a control group of 74 patients without BioZorb placement.…”

Section: Discussionmentioning

confidence: 99%

“…Without a BioZorb device, the postsurgical seroma or surgically placed clips may be used to determine radiation target volume, but these are variable and less precise targets. The BioZorb allows for targeting of the titanium marker clips to delineate the tumor bed for radiation therapy planning . It allows for tissue ingrowth during the healing process and is slowly resorbed by the body over time.…”

Section: Introductionmentioning

confidence: 99%

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Utilization of BioZorb implantable device in breast‐conserving surgery

Srour

Chung

2019

Breast J

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BioZorb fiducial marker is an implantable device made of six clips to mark the surgical site of tissue removal in three dimensions. The marker facilitates focused radiation therapy, while allowing for tissue ingrowth during the healing process with resorption by the body overtime. Current literature investigating the use of the BioZorb is limited and focused on its value for radiation treatment. Our objective was to investigate the feasibility and surgical complications associated with the BioZorb in breast-conserving surgery. From April 2015 to June 2018, 89 patients who underwent 91 partial mastectomies with planned adjuvant radiation therapy and placement of the BioZorb.Demographics, type of BioZorb used, complication rate, and postoperative examinations were analyzed. A total of 89 patients who were a median age of 59 years (range 34-84) underwent 91 operations with BioZorb placement-86.8% underwent a partial mastectomy (n = 79), and 13.2% underwent a breast wide re-excision for margins at the time of BioZorb placement (n = 12). Of the 79 partial mastectomies, 21.5% (n = 17) were palpable tumors. Location of the tumor and subsequent BioZorb placement was most often in the upper outer quadrant (40.7%), followed by upper inner (27.5%), lower outer (20.9%), and lower inner quadrants (10.9%). 92.3% (n = 84) had a single BioZorb placed, 5.5% (n = 5) had two BioZorbs placed in a single lumpectomy cavity, and 2.2% (n = 2) had two BioZorbs placed in separate lumpectomy cavities of the same breast. Of the 10 different tissue marker sizes used, a 2 × 3 cm BioZorb was most commonly used (37/98, 37.8%), followed by 3 × 4 cm (25/98, 25.5%) and 1 × 3 × 2 (9/98, 9.2%). A total of five patients underwent immediate bilateral breast reduction following placement of the BioZorb. Of the 91 operations, 22 patients had a subsequent reoperation for positive margins after initial placement of the BioZorb, of which 86.4% retained the BioZorb. During these reoperations, only 1 patient had the BioZorb removed due to discomfort (4.5%) and two had it removed due to subsequent mastectomy (9.1%). At a median time of 1.1 years, the BioZorb continued to be palpable on clinical breast examination in 63.6% of patients. The longest time that the BioZorb continued to be palpable was 2.8 years. Additional imaging was ordered because a clinician palpated a mass, unaware it was the BioZorb 8.8% of the time 2 × 3 37/98 (37.8) 3 × 3 7/98 (7.1) 3 × 4 25/98 (25.5) 4 × 4 3/98 (3.1) 4 × 5 4/98 (4.1) Low-profile device sizes 1 × 3 × 2 9/98 (9.2) 1 × 3 × 3 3/98 (3.1) 2 × 1 × 1 1/98 (1.0) 2 × 2 × 1 4/98 (4.1) Abbreviation: cm, centimeters.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Utilization of BioZorb implantable device in breast‐conserving surgery

Srour

Chung

2019

Breast J

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“…By mobilizing tissue into the lumpectomy cavity, one avoids the retraction and sinking deformity often seen with simple lumpectomy closure. Mobilization of tissue maintains the normal contour of the breast and enhances appearance [49–51]. Almost 40 years ago, Margolese [11] described methods of improving cosmesis at the time of partial mastectomy based on the NSABP experience of 400 patients.…”

Section: Classification Of Oncoplastic Proceduresmentioning

confidence: 99%

Increasing Role of Oncoplastic Surgery for Breast Cancer

Kaufman

2019

Curr Oncol Rep

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Purpose of ReviewThe goals of surgery for breast cancer have remained the same over the years, to eliminate breast cancer from the breast with the least degree of deformity. With the current expectation of long-term survival after breast cancer treatment, more attention has turned to the cosmetic result of the surgical treatment. Whether lumpectomy or mastectomy, the need for aesthetic improvement was recognized by surgeons both in and outside the USA.Recent FindingsOncoplastic surgery combines the skills of the cancer surgeon with those of the plastic surgeon. Sometimes, this means a team approach with a breast surgeon and a plastic surgeon both performing their mutual skills for the patient. Other times, the properly trained breast surgeon may perform some of the plastic techniques at the time of cancer surgery. Breast surgeons are rapidly gaining the ability to improve the post-cancer treatment appearance. To simplify the classification of oncoplastic techniques, we have used lower level, upper level, and highest level. The assignment of techniques to levels is based on both the technique and the surgeon’s training and experience. Much data has accumulated demonstrating the safety and efficacy of the “aesthetic cancer cure.” We describe the development of oncoplastic surgery, the techniques available, matching the right candidate with the right technique, and some comments about the future.SummaryIt is clear from both clinical benefit and patient satisfaction that oncoplastic breast cancer procedures are here to stay. Plastic surgeons will likely focus on the upper- and highest-level procedures while breast/general surgeons will learn lower-level procedures and some of upper-level procedures as needed by their locale. Opportunities to educate breast/general surgeons in these techniques will continue to increase over the next several years. Formal education in oncoplastic surgery during breast fellowships will be necessary to catch up with the rest of the surgical world outside the USA.

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“…3 That year, the BioZorbÒ was used first in New Zealand, followed by the United States, which provided more benefits than initially expected. 4,5 The main purpose of the device was to better target radiation therapy to the lumpectomy bed due to several noted problems with clip placement. 6 One advantage, among others noted in our report, was that it allowed radiation therapists to avoid treating inadvertent seromas and oncoplastic surgical dissection sites not related to the cancer excision but a byproduct of reconstructive lumpectomy.…”

Section: Presentmentioning

confidence: 99%