Local surgeon uses new device
BioZorb improves cosmetic, overall outcome in breast cancer surgery
EAST NORRITON >> Dr. Jennifer Simmons at Einstein Medical Center Montgomery is one of the first breast surgeons in the area to use a revolutionary implantable device that improves the cosmetic and overall outcome in breast cancer surgery.
There seems to be no better time than Breast Cancer Awareness Month to tout the benefits of BioZorb, a device that has been dramatically upgrading the medical scenarios for Simmons’s lumpectomy patients for more than a year.
“For years I’ve tried different techniques, with tissue arrangement. I thought I should invent a temporary implant, and then someone else invented it,” said Simmons, who admitted she was surprised that so few surgeons are currently using the device.
“It does astound me, but I’ve always been different than all the other breast surgeons. I’ve
always pursued a more cosmetic outcome, so that’s been very important to me from the very beginning,” noted Simmons, who lost count of the number of surgeries where she has used BioZorb. “It could be 100 or 150; I’m not really sure at this point. There is some technique involved with this, which I think is why everyone is not using it. But I’m hugely in support of this product. It’s a game changer. I pride myself on being a breast conservation person, so for people who were told they would otherwise need a mastectomy. I’m a little more aggressive in my approach to breast conservation.”
Additional training in oncoplastics, which combines cancer surgery with plastic surgery to improve cosmetic results, has given Simmons an advantage and prepared her for working with BioZorb, she allowed.
“I think for most breast surgeons, this isn’t the focus of what they do, and it definitely takes more time; there is a learning curve, and you have to be comfortable with tissue rearrangement. So, if those aren’t things you would do normally, then this probably wouldn’t appeal to you,” Simmons said. “But there are a number of tremendous benefits to it.”
Manufactured by Focal Therapeutics, a medical device company that was established to help surgeons, radiation oncologists and other clinicians more easily identify surgical sites, BioZorb was created to help clinicians overcome challenges involved in identifying the tissue excision site for subsequent medical procedures and/or follow-up imaging, according to the company.
The BioZorb marker designates the surgical site of tissue removal in a three dimensional form. The marker itself consists of an open framework structure featuring six titanium marker clips arranged in a fixed fashion to assist visualization on clinical imaging.
BioZorb is put into place at the time of surgical tissue removal and is slowly absorbed by the body over time, Simmons explained. The spiral-shaped implant fills the lumpectomy cavity while supporting the surrounding breast tissue so the tissue doesn’t “sink in,” creating a far better cosmetic outcome.
“During surgery, when you remove the cancer and leave all the normal breast tissue behind, it can be quite deforming,” Simmons said. “The goal of preserving breast is actually to preserve something that resembles the native breast. When it doesn’t, the patient has a constant reminder that they had breast cancer. So, if you’re avoiding a mastectomy and saving the breast, we want to give them a worthwhile result. BioZorb looks like a plastic spiral and serves as a space filler. It works as a lattice, a three dimensional structure that supports the tissue, and fills in the space over time. So that, combined with some movement of the surrounding tissue to allow for coverage of this implant, really preserves the cosmesis of the breast.”
Over time, the implant dissolves, but titanium marker clips remain and mark the spot to help the radiation oncologist see exactly where the tumor was removed so more precise radiation treatment can be delivered to the lumpectomy site after surgery, which reduces radiation exposure to the healthy surrounding tissue.
“The patient has an excellent cosmetic result, but on top of that, it limits the amount of radiation that the patient gets afterwards because now the target for the radiation is this implant rather than how they used to target by using the seroma, which is a fluidfilled cavity. Your body will fill any empty space with fluid, so women got fairly large seromas after their surgery because we weren’t really closing the cavity down. So women got more radiation, and that leads to more scarring. This really changed that, and now they have a better cosmesis because of healing that space and they have less adhesions and less scarring afterward.”
BioZorb is eventually completely absorbed by the body, Simmons said.
“How long it takes to absorb depends on your own enzymatic makeup. Some people’s enzymes will break this down in a year, while with other people, it will take two years.”
BioZorb initially came to Simmons’ attention at a meeting, she recalled.
“I spoke to the company’s rep at that meeting and said, ‘I’m already doing this whole technique; I just need this other piece in it.’ She came to my OR the following week, and it just grew from there. The implants come in many sizes,” Simmons explained, “and the rep is very conservative in recommending the smaller implants. But I now use the bigger ones because I’ve learned the smaller ones don’t work as well. I know that the bigger ones end up looking better and working better. My cosmesis, which was always good, is now excellent. I would say from a psychological benefit, it certainly has tremendous benefit,” she added, “because in the long run, the patients have a breast that more resembles their native breast ... and that’s always a bonus.”
einstein Medical Center Montgomery breast surgeon dr. Jennifer simmons is achieving excellent results for patients with a new implantable device called bioZorb.