XRAYS - Making Sense of Cancer Headlines

FORCE’s eXamining the Relevance of Articles for Young Survivors (XRAYS) program is a reliable resource for breast cancer research-related news and information. XRAYS reviews new breast cancer research, provides plain-language summaries, and rates how the media covered the topic. XRAYS is funded by the CDC.

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Oncoplastic breast-conserving surgery with BioZorb® technology


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Checked Special populations: Women who are candidates for and are considering lumpectomy following a breast cancer diagnosis

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The January 22, 2018 issue of The Columbian included an interview with Dr. Anne Peled in its online report, “Breast cancer surgeon diagnosed with breast cancer advocates oncoplastic surgery.”  Dr. Peled is a 37-year-old breast cancer surgeon and plastic surgeon from California who was recently diagnosed with breast cancer. She underwent oncoplastic lumpectomy—a single surgery that removes the tumor and rearranges the remaining tissue to eliminate any resulting breast deformity. Peled’s procedure included a relatively new technology that she uses for her own patients: an implanted BioZorb® marker, a small device that improves precise targeting of radiation therapy and cosmetic outcome. (2/8/18) 


What is oncoplastic surgery?

Oncoplastic surgery refers to the procedure where a breast is reconstructed after breast-conservation surgery (lumpectomy). A lumpectomy removes the tumor and surrounding tissue. With oncoplastic surgery, the remaining tissue is then rearranged to fill the space or divots left on the breast. The opposite breast may also be modified for symmetry.

Why is oncoplastic surgery important?

According to the Radiological Society of North America, 75 to 80 percent of patients can be treated with breast-conservation therapy (lumpectomy) rather than mastectomy, with similar recurrence results compared to mastectomy. While lumpectomy allows women to forego mastectomy, removing tissue often distorts the size, shape and symmetry of the remaining breast. Radiation treatment compounds the problem. Introduced in the 1980s, radiation therapy revolutionized breast cancer treatment. It kills remaining cancer cells and reduces the risk of recurrence, but it also extends into healthy tissue, shrinking blood vessels and elasticity and further compromising the natural look and feel of the breast.

What is BioZorb?

BioZorb minimizes radiation to healthy tissue, which reduces cosmetic damage in the remaining breast tissue. After the tumor is removed, a walnut-sized BioZorb coil is implanted at the tumor site. Small titanium clips along the framework precisely mark the area to be radiated. Because the exact field of radiation is better defined, more healthy tissue remains unaffected. The article states that the device supports the remaining tissue as it heals, limiting scarring and reducing the likelihood of developing “divots” that many lumpectomy patients experience when tissue is removed. Over a year or more, the BioZorb framework is reabsorbed into the body, while the clips remain as a permanent marker to aid future imaging.

What does this mean for me?

Some women who are diagnosed with breast cancer aren’t interested in other procedures beyond mastectomy—they just want their breast and the cancer gone. But breast-conserving therapy followed by radiation treatment and sometimes chemotherapy has proven to be an effective treatment for early-stage breast cancer.

Many breast cancer patients, however, are unfamiliar with oncoplastic surgery or the BioZorb implant, or they may not have access to a surgeon or facility where oncoplasty is performed. In The Columbian interview, Dr. Peled stated, “Nationally, less than 10 percent of women undergoing a lumpectomy have oncoplastic reconstruction.” By sharing her own experience, she hopes to spread the word about oncoplastic surgery and BioZorb as a way to help improve cosmetic outcomes for many patients after a lumpectomy.

It is important to make a clear distinction between oncoplastic surgery and a device (BioZorb). Oncoplastic lumpectomy does not require the use of BioZorb. In addition, not all breast surgeons perform oncoplastic lumpectomies. This surgical procedure depends on the surgeon. If you are considering lumpectomy, consult with an oncoplastic surgeon and discuss whether the use of a BioZorb implant is a good option for you.

Limitations of the article

The article with Dr. Peled included no discussion regarding prior research on BioZorb. Approved by the FDA in 2012, the device was shown to improve outcomes and follow-up care in two separate studies that were presented at the 2017 Annual Meeting of the American Society of Breast Surgeons.

Questions to ask your health care provider

  • Is a lumpectomy or mastectomy more effective for me?
  • Do you provide oncoplastic lumpectomy? If not, how can I find a surgeon who does?
  • Will I need radiation therapy after my lumpectomy?
  • Can I benefit from a BioZorb implant?

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Posted 2/8/18

References

Breast cancer surgeon diagnosed with breast cancer advocates oncoplastic surgery.” January 22, 2018, The Columbian.  

Leonard KL, et al. “Placement of the BioZorb® marker is associated with smaller irradiated tumor bed in patients receiving breast conserving therapy.” Poster presentation at the 18th Annual Meeting of the American Society of Breast Surgeons, April 26-30, 2017; Las Vegas, NV.

Cross MJ, Jones S, Smith A, et al. “Impact of a 3D bioabsorbable implant on the rate of breast conserving surgery: review of 1,115 breast cancer patients in the private practice setting.” Poster presentation at the 18th Annual Meeting of the American Society of Breast Surgeons, April 26-30, 2017; Las Vegas, NV.

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