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Using ‘Vacuum’ technology to map out breast cancer

The use of ‘vacuum’ power to take tissue samples from the breast, could help surgeons more accurately map out where cancer remains after chemotherapy according to new research led by The Royal Marsden NHS Foundation Trust. 

13 December 2019

Clinicians hope this could help design trials to assess if surgery is necessary for those patients who have totally responded to treatment. 

Patients after undergoing chemotherapy for breast cancer would usually have an imaging scan i.e. mammogram / ultrasound or MRI, to assess their response to treatment. This is then followed by surgery to remove any areas still affected by cancer. 

However previous studies have suggested that these imaging techniques may not precisely reflect where residual disease remains, specifically where it might be small or even non-existent. 

Surgeons looked to combine vacuum assisted biopsy (VAB) with existing imaging techniques, to investigate whether it could provide a more comprehensive picture of the breast, and so help them to plan the procedure more accurately.  

VAB technology acts in a similar way to a standard biopsy; patients are put under local anaesthetic before radiologists use a larger than average needle to take a sample. Unlike normal needles, VAB is attached to a tube that applies a vacuum to extract breast tissue. Clinicians can take more tissue but with a minimally invasive technique. The samples are then sent off to the lab for analysis.

Researchers at The Royal Marsden NHS Foundation Trust, The University of Texas MD Anderson Cancer Centre, and Seoul National University Hospital analysed results from 166 women who had a biopsy following chemotherapy. 143 underwent VAB and 23 had core cut biopsy, another method of image-guided biopsies.

Lead author Mr Marios Tasoulis, Locum Consultant Oncoplastic Breast Surgeon at The Royal Marsden presented the results of the study at the 2019 San Antonio Breast Cancer Symposium in Texas.

They found that a standardised breast assessment protocol using VAB was significantly accurate at identifying areas of residual cancer, and importantly could reliably predict patients who had successfully responded to chemotherapy with no remaining disease. 

 

What is particularly exciting is the potential for this technique to accurately pinpoint women who have completely responded to chemotherapy with no remaining disease.

Mr Tasoulis, Oncoplastic Breast Surgeon at The Royal Marsden

Mr Tasoulis, Oncoplastic Breast Surgeon at The Royal Marsden, said: “This is highly promising data. Our current imaging techniques give us an idea of what disease could still remain following chemotherapy. However VAB appears to be a much more accurate method to establish if and where cancer might still remain. In doing so it offers patients a much more personalised and accurate treatment plan.”

 “What is particularly exciting is the potential for this technique to accurately pinpoint women who have completely responded to chemotherapy with no remaining disease. We are carrying out further research to confirm whether this means those women would not need to have surgery.”
 
‘At The Royal Marsden we are focused on smarter, better and kinder treatment options for our patients,’ Mr Tasoulis added, ‘and thanks to 21st-century tools such as vacuum assisted biopsy we hope to do this.’

The research presented at San Antonio follows on from a smaller study on VAB carried out by Mr Tasoulis, along with colleague Ms Victoria Teoh, also an Oncoplastic Breast Surgeon at The Royal Marsden. Ms Teoh presented the results at the ASCO Breakthrough meeting in Bangkok earlier in October, where she was awarded the Conquer Cancer Merit Ward.