Tuesday, 07 February 2017 00:00

Breast Cancer Symposium

Written by

November 10-11, 2017

Mandarin Oriental - Las Vegas, NV
 

Lead author, Peter Beitsch, with Drs. Paul Baron, Peter Blumencranz, on the NBRST trial with poster results at ASBS 2016.

Presented an analysis of residual cancer after Neo-Adjuvant Chemo. The luminal B, basal type and Her2 type all became less 'aggressive' on MammaPrint Index and less 'luminal' 'basal-like' and less 'Her2-like' on BluePrint. The luminal A patients did not change on either MP or BP. 

Hypothesis is either 1) tumor heterogeneity, with the more aggressive clones being killed off leaving less aggressive ones behind or 2) the pressure from the chemo forced the cancer to adapt and become more resistant to therapy.

 

Wednesday, 15 June 2016 00:00

TME Founder Pat Whitworth on RadioMD

Written by

TME Founder Pat Whitworth on RadioMD

Breast Conservation Surgery - listen   here

Melanie Cole's Health Radio:

"Breast conservation surgery is also known as lumpectomy. For a lumpectomy, the affected breast tissue is removed along with a small portion of healthy tissue surrounding the lump.

The survival rate for breast cancer patients is the same for lumpectomy as for mastectomy (complete breast removal).

A common technique for breast conservation involves inserting a wire in the breast to indicate the target for surgery. This can be very unsettling for the patient as she heads to the operating room.

SAVI Scout involves putting a marker in the center of the targeted tissue. This marker is located via radar. It makes it much easier to find and remove the lump. It's like finding a coin with a metal detector.

Listen in as Dr. Pat Whitworth discusses breast conservation surgery."

 

This study, pioneered by PI Dr. Charles Cox, shows that RADAR localization can replace wire localization. 11 sites across the country contributed 154 patients.The study showed a 100 percent surgical success rate, high satisfaction scores from both physicians and patients, as well as low (16%) rate of re-excision lumpectomy.

Scientific impact award WHITWORTH 2016

 

TME IPEX Registry Investigator Cathy Graham presents poster on her experience with 469 patients at 2016 Annual American Society of Breast Surgery meeting in Dallas.

 

Upstage rates are markedly lower using BLES with U/S guidance (1.16%) than previously published data using large-gauge vacuum assisted core needle biopsy.  Results suggest that high risk lesions can be managed with BLES reducing the need for surgical intervention.

 

Intact Cathy Graham FINAL

Upstage rates are markedly lower using BLES with U/S guidance (1.16%) than previously published data using large-gauge vacuum assisted core needle biopsy.  Results suggest that high risk lesions can be managed with BLES reducing the need for surgical intervention.

Intact Cathy Graham FINAL

 

 

Cathy Graham at ASBS 2016

Cathy Graham

 

TME IPEX Registry Investigator Steve Schonholz presents poster at 2016 Annual American Society of Breast Surgery meeting in Dallas.

 

Retrospective data analysis demonstrates feasibility of complete excision of smaller cancer lesions sized 4-12mm using the INTACT Breast Lesion Excision System (BLES).  In 88% of cases complete excision was achieved, paving the way for minimally invasive management of small breast cancers. 

 

Schonholz ASBS FINAL

Retrospective data analysis demonstrates feasibility of complete excision of smaller cancer lesions sized 4-12 mm using the INTACT Breast Lesion Excision System (BLES).  In 88% of cases complete excision was achieved, paving the way for minimally invasive management of small breast cancers. 

Schonholz ASBS FINAL

 

 

Steve Schonholz at ASBS 2016

Steve Schonholz

Does the Mammography Debate Miss a Key Point?

Dr. Peter Beitsch and Dr. Pat Whitworth discuss evaluation of risk.

April 7, 2016. 

Every time the US Preventive Services Task Force issues a recommendation about when women should start getting mammograms – and how often they should have these screenings – it sends shockwaves through the breast-cancer world.

This last time was no different.

But now two influential breast cancer experts assert that – as important as the debate is – it misses an essential point about evaluating a woman’s individual risk of getting breast cancer.

Those experts – Dallas breast surgeon Dr. Peter Beitsch and Nashville breast surgeon Dr. Pat Whitworth – say the key question is how to evaluate “risk.”

The latest recommendations from the task force call for women at “average risk for breast cancer” to begin every-other-year screening at age 50. It casts doubt on the true value of screening beginning at age 40 – citing the high number of false-positive test results in women 40 to 50, plus potential harm from overdiagnosis and unnecessary treatment.

Many advocates in the breast cancer world maintain that screening should start at age 40 rather than 50. Women who have had breast cancer at an earlier age often credit screening mammography with catching their cancer in time. And of course many of us know someone who has been struck by the disease at an early age.

There is also some scientific evidence to support earlier screening. In contrast, the task force has its own reasons to recommend that screening begins at 50. For some context on those questions, see this discussion from Susan G. Komen.

The debate has become so heated that advocates, including the influential Washington DC-based Tigerlily Foundation, were successful in getting Congress to incorporate thePALS Act into the most recent federal omnibus spending bill.

The bipartisan PALS provision places a two-year hold on the task force’s final screening recommendations for breast cancer.

There’s been an interesting split among clinicians. The American College of Radiology, for example, oppose the recommendations and said that women should get annual mammograms beginning at age 40 – a position outlined in this press release. The American Academy of Family Physicians, by comparison, supported the task force’s recommendations in this statement.

It seems inevitable that this controversy will continue for years. Whatever the outcome, say breast surgeons Pat Whitworth and Peter Beitsch, most people in the debate are overlooking a key point:

In the endless discussions over when women of “average risk” should begin screening mammography — exactly how are women and their physicians to determine who is at “average risk”?

“This is a continuation of an egregious failure of professional societies, medical organizations, the USPSTF, the ACS, the media, and virtually everyone else,” says Dr. Whitworth. He’s one of four physician founders of Targeted Medical Education, a group of leading community-based breast cancer doctors.

“Every one of these groups pays lip service to the ‘individualized discussion between physician and patient’, without empowering women and doctors with the simple fact that individual risk can be more precisely calculated,” he adds.

Many women are familiar with some of the risk factors for breast cancer. They include, to varying degrees:

  • Age
  • Family history
  • Race
  • Carrying the BRCA1 or BRCA2 gene mutation
  • Use of combined hormone therapy after menopause
  • Breast density, and
  • Whether (and at what age) a woman has given birth.

But the general guidance from clinical organizations is often of little help here, asserts Dr. Beitsch, another TME founder: “One such group actually says that women at intermediate risk should ‘consider using a risk assessment model.’ ” He calls that advice “completely bass ackward” and adds: “Decisions about when to begin screening should begin with risk assessment using widely available models. Being 40 and female is no longer adequate for risk assessment.”

So what is the best model to do use?

The Society of Surgical Oncology cites six of them, including the well-known Gail Modeldeveloped by the National Cancer Institute.

Drs. Whitworth and Beitsch, point to the Tyrer-Cuzick model or, in another form, the Hughes RiskApp (after Kevin Hughes, M.D., of Massachusetts General Hospital.) Women wanting to calculate their personal risk can use several different sites, including this website. For physicians there are more sophisticated offerings here.

The doctors at TME are leaders in educating their peers about breast cancer treatment. They’ve also got the right idea about the need for better and more widely available risk assessment.