Researchers Seek to Simplify Breast Cancer Biopsy

Patients with breast cancer undergo numerous procedures, with many being very painful. Patients undergoing a biopsy may experience a wire localization process, which involves a thin wire inserted into the breast tissue to determine the location of the mass prior to surgery.

For patients, this step may be painful, and add more procedures to an already stressful situation. Researchers at the University of Wisconsin-Madison saw an opportunity to create a better localization procedure that was precise and patient-centric, according to a press release from the university.

In this novel method, a radio-frequency tag takes the place of the localization wire, and provides greater precision. The researchers created Elucent Medical to develop this system, and produce better tools for breast cancer.

“It’s not something I think I would wish on anyone,” said Dan van der Weide, PhD, founder of Elucent. “It’s stressful to place this wire on the day of a difficult surgery.”

The localization wire can create problems when providers are searching for a tumor, while preserving healthy tissue. During this process, the wire is inserted during a mammogram or under ultrasound. If the tumor is in the center of the breast, there may be more than 2 inches from the mass to where the wire needs to exit, according to the press release.

“I get a 2-D picture of where the wire is in the breast, but it’s a 3-D event — and requires piecing the pictures together to find the cancer,” said Lee Wilke, MD, FACS, director of the University of Wisconsin Health Breast Center and a professor of surgery.

Even the most successful localizations can leave much work for surgeons, since only 1 point is marked.

“The wire can be very biased, because it only comes from one direction,” Dr Wilke said. “It’s been this way for more than 30 years.”

A possible solution is to place a radioactive pellet in the tumor, and track it through a detector. However, since clinicians are regularly exposed to radiation, putting them more at risk is not a viable solution.

Radio frequency identification (RFID) technology is currently used in day-to-day life, and offers an accurate and safer solution to this complicated issue. Today, RFID is used in pets that are microchipped, and provides information to the person who scans the chip so that the animal can be returned to their home.

A challenge the researchers faced was creating a novel RFID tag that could provide clinicians with a clear view of the tumor, according to the release.

“There’s no facility for saying, look, the tag is exactly 3.5 cm deep and over 1 cm from where your reader is,” Dr van der Weide said.

The investigators are now creating a coil array that wraps around an RFID tag to provide a precise location via a wand-like reader, according to the university.

Dr Wilke and other surgeons have expressed interest in alternatives to the localization wire if it is easy to learn. The researchers have said that the new system would not be too complex, and may even result in decreased costs.

Since the tag can be implanted while during the biopsy, the wire and localization procedure would be irrelevant. This could save up to $2500 per patient, according to the release.

The researchers are working to perfect the design of the device, and subsequently pursue regulatory approval. Re-thinking outdated procedures, such as wire localization, can improve the standards of care for patients with breast cancer while decreasing costs.

“A lot of medical procedures evolved out of an immediate need, and common sense and simplicity weren’t at the forefront,” Dr van der Weide concluded.