Breast Cancer Treatment Developed By UAMS Surgeon

[gdpawel]

A breast cancer treatment developed by University of Arkansas for Medical Sciences (UAMS) surgeon V Suzanne Klimberg, M.D., has been shown in a clinical trial to reduce the need for repeat surgery following lumpectomy by 86 percent.

Klimberg, director of the breast cancer program at UAMS' Arkansas Cancer Research Center, is the principal investigator of a multiphase clinical trial for the new procedure called Radiofrequency Ablation (RFA)-Assisted Lumpectomy. The findings of the study were presented this week at the American College of Surgeons 91st Annual Clinical Congress in San Francisco.

The RFA procedure, which sears a one-centimeter margin, or perimeter, of soft tissue following standard lumpectomy removal of a breast tumor, is intended to give the patient a cancer-free area around the site where the tumor has been removed so that a second surgery in the area around the lumpectomy and/or radiation therapy are unnecessary. Currently, about 40 percent of patients require a second surgery to remove additional malignant tissue.

UAMS is the first hospital to use RFA-assisted lumpectomy to treat breast cancer. Klimberg's recently concluded trial involved 25 breast cancer patients.

Klimberg is chief of the Division of Breast Surgical Oncology at UAMS and a professor in the Departments of Surgery and Pathology. She is a staff physician in the Women's Oncology Service at the Central Arkansas Veterans Healthcare System as well as director of Breast Fellowship in Diseases of the Breast and director of the Breast Cancer Program at UAMS.

The RFA-assisted lumpectomy begins with standard removal of the tumor. Then, an RFA probe is inserted and heated to 100 degrees for 15 minutes, creating a one centimeter zone of dead tissue around the cavity.

"Since 90 percent of local breast cancer recurrences are at the site of the original tumor, the RFA procedure gives women added assurance that they will not need a second surgery to remove cancer at the same site," Klimberg said. "The success of this procedure is important not only for UAMS, but for every woman who experiences breast cancer and every doctor who treats it."

Of the 150,000-200,000 patients who undergo lumpectomies each year, about 25 percent refuse or are unable to receive follow-up radiation treatment. Through the use of RFA, the area around the lumpectomy cavity is eradiated during surgery.

"With the use of RFA, we are more successful in eliminating the cancer during the first surgery. We also can prevent the need for a second surgery, reduce or eliminate the need for additional radiation treatment and improve the cosmetic result," Klimberg said. "Ultimately, any patient eligible for lumpectomy may be eligible for treatment with breast-sparing RFA."

Other UAMS physicians and staff participating in the study were Soheila Korourian, M.D., associate professor, Department of Pathology; Julie A. Kepple, M.D., oncology fellow; Ronda S. Henry-Tillman, M.D., associate professor of surgery and director of the UAMS Cancer Control Department; Aaron Margulies, instructor of surgery and second-year Breast Fellow; Laura L. Adkins, project program specialist; Scott Ferguson, laser safety officer; and G. Shafirstein, Ph.D., assistant professor, Department of Otolaryngology/Head and Neck Surgery.

UAMS is the state's only comprehensive academic health center, with five colleges, a graduate school, a medical center, five centers of excellence and a statewide network of regional centers. UAMS has about 2,320 students and 690 residents and is the state's largest public employer with almost 9,000 employees. UAMS and its affiliates have an economic impact in Arkansas of $4.3 billion a year.

UAMS centers of excellence are the Arkansas Cancer Research Center, Harvey and Bernice Jones Eye Institute, Donald W. Reynolds Institute on Aging, Myeloma Institute for Research and Therapy and Jackson T. Stephens Spine & Neurosciences Institute.

http://www.uams.edu/update/absoluten...4091&zoneid=35

[janet/FL]

No radiation needed? Wow

[gdpawel]

A surgeon at the University of Arkansas for Medical Sciences (UAMS) has developed a new procedure to prevent one of the most common side effects associated with breast cancer treatment – lymphedema or swelling of the arms due to faulty drainage of the lymph nodes.

V. Suzanne Klimberg, M.D., director of the UAMS breast cancer program, led a study funded by the Tenenbaum Breast Cancer Research Foundation of breast cancer patients at risk for developing lymphedema. Her findings were published in the February issue of the Annals of Surgical Oncology, and she will present the study March 17 at the Society of Surgical Oncology 60th Annual Cancer Symposium in Washington, D.C.

"The removal and analysis of the lymph nodes under the arm remains the most important factor in determining the severity of disease in breast cancer patients," Klimberg said. "In the past, surgery to remove the lymph nodes and most of the fat and tissue in the armpit often resulted in complications, including lymphedema." Five percent to 50 percent of women undergoing surgical treatment for breast cancer have developed lymphedema, mainly dependent upon the extent of surgery.

At the ACRC, surgeons determined that the draining of the first lymph node, known as the sentinel lymph node, is capable of predicting if the cancer has spread to the remaining armpit lymph nodes, known as axillary lymph nodes. This is a less invasive surgery and reduces the likelihood of complications.
However, the lymph node system is at risk of disruption during either a sentinel lymph node biopsy or an axillary lymph node dissection, which often leads to swelling in the arm.

To prevent the arm swelling, Klimberg has developed the Axillary Reverse Mapping (ARM) procedure. The new technique evaluates the ways in which fluid drains through the lymph node system in the arm through the injection of blue dye. The dye is used to map the drainage of the arm.

"Mapping the drainage of the arm decreases the chances of unintended disruption of the lymph node system during surgery and reduces the risk of developing swelling in the arm," Klimberg said. "We are the first to study lymph node drainage in the arm and are now using the ARM procedure as standard procedure at UAMS.

Klimberg will soon begin conducting training seminars on the procedure throughout the country. The seminars will be sponsored by the global medical device company Ethicon, a branch of Johnson & Johnson.

Klimberg is chief of the Division of Breast Surgical Oncology at UAMS and a professor in the Departments of Surgery and Pathology. She also is director of the Breast Cancer Program at the UAMS’ Arkansas Cancer Research Center as well as director of Breast Fellowship in Diseases of the Breast at UAMS.

Additional UAMS staff members involved in the published study are Kent Westbrook, M.D.; distinguished professor; Ronda Henry-Tillman, M.D., associate professor of surgery; Margaret Thompson, fellow; Soheila Korourian, M.D., associate professor of pathology; Keiva Bland, fellow; K. Jackman, surgery resident; and Laura Adkins, data manager.

UAMS is the state’s only comprehensive academic health center, with five colleges, a graduate school, a medical center, six centers of excellence and a statewide network of regional centers. UAMS has about 2,430 students and 715 medical residents. It is one of the state’s largest public employers with about 9,400 employees, including nearly 1,000 physicians who provide medical care to patients at UAMS, Arkansas Children’s Hospital, the VA Medical Center and UAMS’ Area Health Education Centers throughout the state. UAMS and its affiliates have an economic impact in Arkansas of $5 billion a year.

http://www.uams.edu/update/absoluten...6124&zoneid=35