Dr. Melanie Friedlander with South Bay Surgeons specializes in General Surgery, Breast Surgery, Advanced Laparoscopic Surgery, Thyroid and Parathyroid surgery. She was appointed Clinical Instructor of Surgery at the University of Southern California in 1999 and is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the Society of Laparoscopic Surgeons. Dr. Friedlander currently has a strong focus on breast cancer surgery and a unique perspective as a breast cancer survivor.
In approximately 25 cases, Dr. Friedlander has had the chance to work with MarginProbe®, the latest tool to help ensure clean margins in breast conserving surgery for both ductal carcinoma in situ (DCIS) and invasive breast cancers. DCIS is the presence of abnormal cells inside a milk duct in the breast. DCIS is considered the earliest form of breast cancer and is noninvasive, meaning it hasn’t spread out of the milk duct to invade other parts of the breast. Dr. Friedlander reports that MarginProbe has been “phenomenal” for checking the margins of patients with DCIS. She feels that it has reduced the number of patients that have positive margins as a finding on their final pathology report.
“Before MarginProbe, I would perform the lumpectomy, I would x-ray the specimen, and then we would send it to the pathologist to be fixed in formalin,” stated Dr. Friedlander. “After the surgery, they would stain it and look at it under the microscope, but it would be several days before we would find out if our margins were clear or not. Since I’ve been using the MarginProbe, when I do a lumpectomy for DCIS, I actually use the MarginProbe in the operating room. If it tells me I need to remove additional tissue from any of those edges, we can do it right at that time. It significantly increases the chance of getting good margins on the first surgery.”
“The greatest thing about the MarginProbe, other than the fact that it works, is that it’s so easy to use,” she continued. “The technology is brilliant, but from a technical standpoint on the surgeon side, there’s very little that you have to do. You basically just press the probe against the lumpectomy specimen on each side and it gives you the information. It works extremely quickly, and there’s really not a lot that’s left to user error.”
The MarginProbe Difference
Dr. Friedlander feels strongly that when using the MarginProbe, a surgeon operating for DCIS is going to do a better job for the patient. It also enables the hospital to hold a leadership position in breast cancer treatment in a highly competitive landscape.
“There’s really no downside,” explained Dr. Friedlander. “Using MarginProbe is a perfectly safe thing to do. It doesn’t affect your complication rate in any way, shape, or form. From a surgeon’s perspective, why wouldn’t you want more information?”
Dr. Friedlander highlighted other positive effects of MarginProbe. “I once had a patient that I did a lumpectomy for DCIS, and the MarginProbe said that she had two positive margins, so I re-excised tissue from those two margins,” she said. “When the final pathology report came back, those two margins were still positive. That was such a significant additional piece of tissue that at that point I counseled the patient to have a mastectomy and she agreed. She wound up having very extensive DCIS that her x-rays had not predicted.”
“The MarginProbe was even more helpful in that scenario because, not only did it find the positive margins, but it allowed me to remove additional tissue that really showed us what was going on at the first surgery,” she continued. “A patient like that normally will go back for a re-excision and then still wind up going back for a mastectomy.”
The Future of MarginProbe
Dr. Melanie Friedlander sees her facility joining others in using MarginProbe as a highly effective tool for treating invasive breast cancer, as it is already approved for that application. In fact, this system has already been widely accepted in invasive breast cancer cases.
Interested in learning more about the MarginProbe system, or putting it to use in your practice? Contact us at email@example.com. You can also see and hear from more surgeons who put MarginProbe to use in their practices here.
|Dr. Melanie Friedlander
Association of South Bay Surgeons