A safer course

Changing how breast cancer tumours are marked for surgery makes care more precise and less invasive.

In the world of cancer care and research, Dr. May Lynn Quan is a superstar. As medical director of the Calgary Breast Health Program, scientific director of SPHERE (Strategies for Precision Health in Breast Cancer), general surgery site lead at the Foothills Medical Centre, and professor in the University of Calgary’s Department of Oncology, Quan has dedicated her career to breast cancer.

The common thread running through Quan’s work is her determination to make breast cancer care as comfortable and effective as possible. To that end, Quan is currently involved in a new pilot project co-funded by Calgary Health Foundation and Alberta Cancer Foundation that is set to revolutionize the way women in Calgary experience breast-preserving cancer surgery.

Dr. May Lynn Quan

Pinpointing mammogram-detected tumours — which are too small to locate through manual examination before surgery — can be a difficult process when a surgeon’s wish is to preserve a patient’s breast.

Traditionally, on the morning of surgery, a patient visits an imaging facility where a radiologist inserts an uncomfortable wire next to the tumour, which protrudes from the breast. The patient must then travel to a surgical centre within hours of the implantation to have the tumour removed, sometimes located across the city, without accidentally moving the wire.

“Hook wires have been the standard for decades,” Quan says. “The good news is we have made progress and have other ways to identify these lesions.”

For the last five years, Quan has pivoted to implanting radioactive seeds to mark these small tumours. Read with a Geiger counter, these seeds eliminate the invasiveness of the hook wire and the stress associated with travel. But they have their own drawbacks, mainly associated with the dangers of radioactivity.

The new pilot uses a product called Magseed®, which, like the radioactive seeds, involves placing a metallic marker resembling a grain of rice at the tumour site. Unlike the radioactive version, Magseed allows surgeons to magnetically locate the marker and, therefore, the tumour, without using radioactivity. This means the seeds can sit safely in the breast without risk of dislodging or pain, allowing for less urgent and complicated scheduling, and fewer imaging appointments.

The three-year pilot will allow patients who would have previously been given a hook wire to be fitted with Magseed markers instead. Quan hopes the pilot will irrefutably prove the benefits of the Magseed so they become the standard of care throughout the province.

“This technology allows us to be efficient with our healthcare resources to improve the patient journey,” she says. “We’re very excited about the funding to bring it to Calgarians and to provide data for the rest of the province so that we can hopefully bring it to women across Alberta.”

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