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Radioactive 'seeds' help locate small breast tumors

Heidi Murrin | Tribune-Review - Dr. Kathleen Erb and Dr. William Poller, with the Allegheny General Hospital Cancer Center, explain the radioactive seed localization procedure for breast abnormalities at the center Friday, August 9, 2013.
<div style='float:right;width:100%;' align='right'><em>Heidi Murrin  |  Tribune-Review</em></div>Dr. Kathleen Erb and Dr. William Poller, with the Allegheny General Hospital Cancer Center, explain the radioactive seed localization procedure for breast abnormalities at the center Friday, August 9, 2013.
Heidi Murrin | Tribune-Review - A radioactive seed and a needle that are used in a radioactive seed localization procedure for breast abnormalities Friday, August 9, 2013. Doctors at Allegheny Health Network are offering a more patient-friendly technique for pinpointing the location of abnormalities and tumors.
<div style='float:right;width:100%;' align='right'><em>Heidi Murrin  |  Tribune-Review</em></div>A radioactive seed and a needle that are used in a radioactive seed localization procedure for breast abnormalities Friday, August 9, 2013.  Doctors at Allegheny Health Network are offering a more patient-friendly technique for pinpointing the location of abnormalities and tumors.
Heidi Murrin | Tribune-Review - A very small radioactive seed (white, elongated , middle right)can be seen in an x-ray of a breast at the Allegheny General Hospital Cancer Center Friday, August 9. 2013. Doctors at the Allegheny Health Network are offering a radioactive seed localization procedure that is more patient-friendly.
<div style='float:right;width:100%;' align='right'><em>Heidi Murrin  |  Tribune-Review</em></div>A very small radioactive seed (white, elongated , middle right)can be seen in an x-ray of a breast at the Allegheny General Hospital Cancer Center Friday, August 9. 2013.  Doctors at the Allegheny Health Network are offering a radioactive seed localization procedure that is more patient-friendly.
Sunday, Aug. 11, 2013, 9:00 p.m.
 

William Poller rattled the tiny vial of radioactive material in front of a gleaming screen filled with images of cancerous mammograms.

“This little guy right here, you see it?” he said, plopping the pellet beside a handful of formidably long needles. “This is making a big difference for patients with small breast lesions.”

Poller, director of breast imaging at Allegheny Health Network, is one in a team of physicians implementing a new technique for pinpointing small breast tumors using implanted radioactive seeds about the size of a grain of rice that allow surgeons to target the tiny tumors less invasively.

The new method gives patients and surgeons greater flexibility to schedule and complete the procedure while minimizing discomfort, breast surgeon Kathleen Erb said.

Previously, patients came in a few hours before their surgery so radiologists could insert a thin wire into the tumor using a long, hollow needle. Surgeons used the wire to help locate the tumor for removal.

“But the best point of entry to connect the wire to a tumor may or may not be the best or least invasive way to approach the tumor surgically,” Erb said. “With the radioactive seeds, patients can come in one to five days before the procedure without all the down time or discomfort.”

Surgeons use gamma probes to find the seed, carving around it and the nearby tumor. Erb said seed localization is an option only for patients for whom breast preservation is deemed a safe treatment option.

Piloted by the Mayo Clinic, the procedure took about a year to bring to Allegheny County. Erb and several colleagues traveled to a Mayo affiliate in Jacksonville for intensive training followed by months of paperwork when they returned.

“It took a while to get everything approved and rewrite some of the protocol, but we've performed maybe a dozen now,” she said. “It seems like most surgeons find pretty quickly they really prefer the seed to the wires. Certainly that's true for me.”

A 2010 study published in the American Journal of Surgery found using the radioactive seeds reduced the need for repeat surgery by 50 percent compared to the wire method. The procedure is performed in hospitals nationwide, including cancer treatment centers in Nebraska, New York, Iowa, Colorado, Arizona, Florida and Michigan.

Megan Harris is a staff writer for Trib Total Media. She can be reached at 412-388-5815 or mharris@tribweb.com.

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