Lo­cal sur­geon uses new de­vice

BioZorb im­proves cos­metic, over­all out­come in breast can­cer surgery

The Review - - FRONT PAGE - By Gary Puleo gpuleo@21st-cen­tu­ry­media.com @mus­tang­man48 on Twit­ter

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.”

SUb­Mit­ted PhOtO

ein­stein Med­i­cal Cen­ter Mont­gomery breast sur­geon dr. Jen­nifer sim­mons is achiev­ing ex­cel­lent re­sults for pa­tients with a new im­plantable de­vice called bioZorb.

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