A seed device that acts as a GPS for surgeons to locate and remove breast and lymph node tumours has been found to be safe and effective in a new study.
The feasibility study evaluating the use of the devices, called SmartClips, was carried out by researchers at the University of Cincinnati Cancer Center and their findings were recently published in the journal The American Surgeon.
The research team reviewed 100 patients whose tumours were marked, or localised, using SmartClips.
The SmartClips were found to be equivalent in aiding surgeons in localising and removing the tumour compared to the traditional technique using a needle and wire and may be safer when used to mark lymph node tumours for excision.
The traditional needle and wire technique is typically done on the day of surgery and can be cumbersome and uncomfortable for patients. SmartClips can be implanted at any time prior to surgery, and surgeons can quickly learn the technique needed to use them in the operating room.
Jamie Lewis, a Cancer Center physician-researcher and associate professor of surgery in the UC College of Medicine, and her colleague Elizabeth Shaughnessy, helped test the SmartClip devices as they were being developed.
Lewis said: “We went a few times and saw the different prototypes, worked with them, and provided feedback. Then we were one of the first institutions to use the SmartClips when they became commercially available in 2020. I’ve done more surgeries than any other surgeon with the SmartClip.
“The patient doesn’t have this needle and wire coming out of their breast that we’re trying to work around the day of surgery that may limit our ability to use a certain incision. There’s always a risk when patients are undergoing localisation that they can pass out. So if the localisation is performed on a different day, we reduce the need to cancel their surgery and delays in localisation don’t slow down the progress of the day.”
Lewis said using SmartClips improves efficiency since radiologists can schedule the implantation when it works best for them, and patients’ day of surgery is also shorter.
“Most people prefer two visits rather than one very long day, and they like the idea of not having the needle and wire sticking out,” she said.
“But I think the real benefits from my perspective are the facilitation of the operative schedule and not interfering with the surgeons’ choice of incision.”
SmartClips are one of a number of devices, including radioactive, radiofrequency and magnetic seeds, that have been introduced to better localise breast tumours.
Lewis said the move to these new devices and eliminating the wire and needle technique is a positive development for patients and clinical teams, though a full cost-benefit analysis should be conducted in the future.
She added: “There’s still some technical glitches with it, but I do think that a device like this or another iteration of the future is definitely where we should go.
“Patients definitely seem to be happier, I think surgeons are happier, the radiologists are happier, and it makes the flow of patients through procedures much better. There are some improvements that could be made, but getting rid of needles and wires will help with a number of those things.”
