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Breast cancer surgery in your lunch break

By PAT HAGAN, Daily Mail 09:00am 4th July 2006

A woman has a breast scan: the new procedure is used on benign tumours

A new machine that cuts out tumours within minutes means women can have surgery to remove lumps from their breasts in a lunch hour.

The high-tech equipment slices up tissue into tiny pieces and then vacuums it out of the body. All that's left is a four-millimetre wound which heals quickly and leaves no scar.

The new procedure, which is being trialled at the Princess Grace Hospital in London, is expected to transform breast surgery for thousands of women.

At the moment, it is only being used on benign tumours, but doctors hope to extend its use to malignant growths.

'The whole procedure might last half an hour but it takes no more than five minutes to cut out the tumour,' says Dr Nick Perry, clinical director of the hospital's Breast Care Centre.

'At the moment, these women have to endure an overnight stay in hospital, a general anaesthetic and open surgery in theatre. After all that, they are left with a sizeable scar.'

Every year in the UK, thousands of women have benign lumps removed from their breasts. Although tests will have revealed the tumours are not cancerous, there is no guarantee they will not become malignant later. For peace of mind, many women have the lumps cut out.

In some hospitals, these operations can be done as day cases. Patients have a general anaesthetic but can still go home in the evening. However, experts claim the availability of day-case operations is limited and a majority of women stay in hospital for at least one night.

The new technique uses a machine called Soros. Doctors at the Princess Grace Hospital are the first in Europe to try it. The patient lies down on a bed and a hand-held ultrasound monitor is moved over the breast to pinpoint the tumour.

Once the lump has been found, a local anaesthetic is given to numb the area. Then a tiny incision is made in the skin to give entry for the vacuum device.

This is about the thickness of a ball-point pen and has a special needle on the end. It is fed into the breast and guided into position using the ultrasound image.

The needle has a tiny opening in the end with a miniature blade inside. Once it is next to the tumour, a button is pushed to create a vacuum which sucks tissue into the needle's opening.

As this happens, the blade spins round to shred the tumour and the debris is sucked out. This is repeated until all of the mass has been destroyed. The needle is withdrawn and a plaster stuck over the wound. Patients do not even need to have stitches.

Surgery in under an hour

'It's a tiny nick in the skin and it heals beautifully,' says Dr Perry. 'There have been other vacuum devices before but they would take up to 30 minutes, by which time there would be lots of bruising in the breast.

'So far we have treated 25 women. It can be used for lumps up to three centimetres in size and the majority of benign growths in the breast are less than that. But the real benefit is women can go home within the hour or even go back to work.'

The equipment costs around £30,000 to buy, but hospitals could recoup this money by saving on theatre time and keeping patients out of hospital beds.

Susan Owen, who lives in Gerrards Cross, Buckinghamshire, was the first woman in Britain to have the procedure. Originally from Houston in Texas, Susan, 46, has lived in the UK for five years. But it was during a trip to Houston last December that a routine mammogram found some hard tissue in her breasts.

A trained mammographer, Susan knew it was common for women to have benign growths. On her return home, she had two biopsies. These showed the growths in her left breast were nothing to worry about.

But the results for her right breast showed that Susan, a mother of three, had tiny growths which can, in rare cases, be surrounded by cancer cells or have cancer cells hidden inside them. She had the new procedure in January this year.

'I got to lie down for the whole of it,' says Susan. 'That was a relief because, for some breast biopsies, you have to sit up, which can be uncomfortable.

'Then they used local anaesthetic to numb the area so they could put the needle in. There was no pain at all and the whole thing was over in about 20 minutes. I even had time to stop for lunch on the way home.'

For more information, contact the Princess Grace Hospital on 020 7486 1234 or visit www.theprincessgracehospital.com.

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Here's a sample of the latest comments published. You can click view all to read all comments that readers have sent in.

As a man who has had Breast Cancer and endured a full mastectomy followed by months of Chemotherapy and Radiotherapy - will I be able to be treated in the same way?
You only here about Breast Cancer affecting Women but some 300 men are diagnosed every year.

- David Wrigley, Brighouse England

I am horrified and appalled that such a technique as this is even considered for benign tumours, let alone malignant ones.

Firstly it is well known that even exploratory surgery and biopsies themselves can promote tumour formation. And secondly, as Clinical Oncology points out:

‘Needle biopsy is occasionally used . . . a needle track may harbor nests of cells which may form the basis for a later recurrent spread . . . Incisional biopsy of certain highly malignant tumors through an open operative field may be contraindicated because of risk of spread of the tumor throughout the operative field.’

If this can happen when a small piece of tumour is excised and removed for testing, how much more likely is the spread of cancer with the shredding of a tumour?

I repeat, I am appalled.

References
Kearney R. Factors affecting tumour growth. Int Clin Nutr Rev 1988; 8: 62
Rubin P, ed. Clinical Oncology for Medical Students and Physicians: 6th Edition.

- Dr Barry Groves, Oxford , England

Of course, this is wonderful news, but the angle of the reporting worries me: doesn't a woman with breast cancer deserve more time than her lunch hour to deal with it? Is it too much to ask to have a few days off work to come to terms with the psychological impact of having such a serious disease and undergoing what is, still, major surgery? Should we really be so obsessed with work that we rush back after surgery to clinch another deal/answer another complaint/teach another class? The British seem to me to undervalue their health, and to fail to appreciate the mind-body continuum, to a frightening extent.

- Helene , France