The localization wire was one of the most outrageous aspects of my breast cancer surgery. The thin wire is inserted into the breast through a needle to help mark the location of a tumor on the day of surgery. In my case, the wire then was covered with a Dixie cup—yes, a Dixie cup—to protect it while I was wheeled toward surgery. This was especially humiliating because I had the wire inserted in a clinic and then was then transported through a well-populated atrium to the hospital with that cup sticking out of my cup.
Certainly, I thought, this isn't common. Turns out it is and it is still happening. (Without the extra cup, I hope.) But a team of docs at the University of Wisconsin-Madison are hoping to make some changes.
The team's solution: a system that replaces the localization wire with a radio-frequency tag that helps the surgeon track the tumor's location with greater precision.
"It's not something I think I would wish on anyone," says Dan van der Weide, a UW-Madison professor of electrical and computer engineering. "It's stressful to place this wire on the day of a difficult surgery."
And to an engineer's eye, the localization wire creates all kinds of obstacles to the end goals of removing a tumor while preserving as much healthy breast tissue as possible. For example, the wire is inserted when the breast is compressed in a mammogram machine or under ultrasound guidance. If the mass or cancer is in the center of the breast, there may be a distance of more than two inches from that mass to the skin where the wire must exit.
"I get a 2-D picture of where the wire is in the breast, but it's a 3-D event—and requires piecing the pictures together to find the cancer," says Lee Wilke, director of the UW Health Breast Center and a UW-Madison professor of surgery.
Even at best, the localization wire is simply marking one point along the boundary of the tumor, leaving it to the surgeon to figure out the rest of the picture. "The wire can be very biased, because it only comes from one direction," Wilke says. "It's been this way for more than 30 years."
One possible workaround is to implant a small radioactive pellet at the location of the tumor, then track it with a handheld radiation detector. But Wilke points out that cancer clinicians are already exposed to a lot of radiation, and putting them at even more risk obviously isn't good for anyone.
Radio frequency identification (RFID), a widespread technology with many applications in tracking and communication, offers a compromise.
Because the tag could be implanted while the patient undergoes a biopsy, it essentially eliminates not only the wire but also the entire localization wire-implant procedure, which, according to a news release, "can save up to $2,500 per patient."
My question: $2500? Is that what we were paying for that wire? I wonder if I got charged extra for the cup.
Source: News release from the University of Wisconsin-Madison.
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