Columbia Memorial | Health Compass | Summer 2020

Over the past five years, CMH’s surgery, radiology and oncology teams have worked together to build the region’s most innovative options for breast cancer treatment. “We have access to the same quality and caliber of technology that they use in the bigger cities,” says Juliette Moore, MD, general surgeon. It starts with a mammogram. The CMH Imaging Department offers the most accurate and comfortable mammogram available — Genius 3-D mammography with SmartCurve . It provides better, earlier breast cancer detection with 3-D imaging. If the radiologist sees a lesion on the mammogram, the next step is often a stereotactic needle biopsy. When someone has been identified as having breast cancer, they immediately have the support and expertise of a large, multidisciplinary breast cancer team. The teammeets every two weeks to review the cases of all new breast cancer patients and recommend treatment using the latest evidence-based medicine. “It plays a really important role in making sure that we’re treating the patient as a person and not a disease process,” Dr. Moore says. Once the patient and their doctor decide on a course of treatment, CMH General Surgery orchestrates surgical removal of the cancer and follow-up treatment with an oncologist. New technology improves that treatment at every step. Before surgery, the radiologist marks the tumor with a radiofrequency identification (RFID) tag. Dr. Moore and her fellow surgeons use the RFID tags to precisely locate and remove tumors. Surgeons also will often look for cancer in surrounding lymph nodes using a visible dye and the radioisotope Lymphoseek . Lymphoseek makes sentinel node biopsies much less painful, identifies the lymph nodes much faster and provides the most accurate detection rates. With a Faxitron machine in the operating room, the surgical team can look for evidence of cancer in real time. This technology reduces the amount of time a patient spends in the operating room, making the surgery safer — and less expensive. After a tumor is removed, the surgeon places Biozorb 3D in the space left behind. Biozorb is a scaffolding material held in place by small titanium clips. Over time, the body absorbs the material, much like dissolving stitches. “Biozorb helps tissue to gradually heal into place, resulting in better cosmetic outcomes after surgery, and the implanted markers help us to be more confident in our accuracy during radiation therapy,” says Pehr Hartvigson, MD, radiation oncologist. “It decreases the amount of scarring left behind after breast surgery, which makes it easier to detect any recurrence,” Dr. Moore adds. “Plus, the titanium clips left behind help mark the place of the previous cancer so the radiologist can know exactly where to keep a closer eye in later mammograms.” High-tech care boosts breast cancer treatment Laparoscopic surgery for faster recoveries Cutting-edge care Over the past several years, the greatest shift in the operating room has been from open surgeries to laparoscopic surgery , also known as minimally invasive surgery. “Since I arrived at CMH in 2014, we have introduced a number of laparoscopic procedures that were not available before,” says general surgeon Camilo Rosales, MD. All CMH surgeons commonly use laparoscopic surgery to do appendectomies, repair hernias, remove all or part of the colon, free the small bowel from scar tissue adhesions, diagnose cancer in the abdomen, and more. “Laparoscopic surgery reduces recovery time,” Dr. Rosales says. For example, “Typically, an open inguinal hernia surgery will take about six weeks to recover from. Most people who have laparoscopic inguinal hernia surgery can resume normal activities in two weeks, if the hernia is not large. Laparoscopic inguinal hernia surgeries are also less likely to result in chronic pain.” Camilo Rosales, MD Rachel Van Dusen, MD, and Juliette Moore, MD 6 HEALTH COMPASS FALL 2020