Jun 18, 2018

LOCalizer Q&A with Dr Dona Hobart, Breast Surgeon, Carroll Hospital

We recently spoke with Dona Hobart, M.D. Breast Surgeon and Medical Director of the Center for Breast Health at Carroll Hospital to learn more about her experience with the LOCalizer system.  Read the full interview below…

Q: Tell us a bit about yourself, your role at Carroll Hospital and how you're  using LOCalizer? 

A: I am the medical director of the Center for Breast Health at Carroll Hospital.  I am currently using the LOCalizer for all non-palpable lumpectomies.  We have been using the LOCalizer for just under 2 months now.

Q: Prior to implementing LOCalizer, how did Carroll Hospital localize breast lesions?

A: Previously we used a radioactive seed for localization.

Q: What were the driving factors for Carroll Hospital in finding and implementing LOCalizer? In other words, what problems were you looking to solve with a new and/or evolved breast localization technique?

A: We encountered several problems with the radioactive seed.  One of the main drawbacks was of course the regulations surrounding the nuclear aspect of the radioactive seed.  There is a significant amount of paperwork as well as required processes surrounding its use.  There are also restrictions in terms of use of suction in the operating room as well as the need to process the specimen without prior fixation.  This caused a significant amount of time to be lost in terms of the pathology department and additionally we felt as if it would be more ideal to assess the margins of our specimens after fixation of the specimen. 

We also had difficulty in terms of motion of the seed.  The seed is completely smooth without any traction in the tissue and therefore we had several cases where the seed had migrated from its original position. This made identifying the lesion much more difficult in addition to causing us to take out further normal tissue to remove the seed.  

This seed also did not have a consistent signal.  Each seed differed in strength.  This caused difficulties in terms of identifying exactly how far away we were from the seed.

The scheduling of placement of the radioactive seed was also problematic.  Having the five-day deadline to get the seed removed was very stressful at times.

Q: How has LOCalizer helped to solve these challenges? What’s most important to highlight?

A: The LOCalizer has been excellent in giving me the ability to precisely identify its location and mold my lumpectomy specimen according to its placement and the previous radiological studies showing the size of the lesion.  One can truly determine how much tissue you wish to remove surrounding the lesion. It also stays in place without any migration.

It has allowed us to fix our specimens prior to processing and has decreased our intake time approximately 15 minutes per case in pathology. The scheduling has been much easier and the ability to leave the tag in place for 30 days has freed our radiology colleagues schedule up significantly.  We will also be able to use more of our staff to place the tags as they will not have to be certified in the handling of nuclear material.

Q: Why did you select LOCalizer from Faxitron over other systems and/or approaches? Were there any “must-have” functionalities that LOCalizer fulfilled? 

A: The LOCalizer filled all of my needs.  It was able to be measured at depths of up to 6 cm and additionally is compatible with MRI.  The depth is particularly important with our larger patients.  Other comparable products can only be measured to approximately 3 cm. 

The ability to exactly measure the distance and to have each tag have an individual identifying number was also very attractive.  We also would not be required to change any of our operative equipment, which would keep cost down.

Q: What benefits has Carroll Hospital seen from using LOCalizer? 

A: I think our benefits will continue to grow as we use the LOCalizer over time.  I personally am finding it a huge benefit in terms of tailoring surgery appropriately.  The ability to measure specimens exactly has been amazing for my patients.  I fully expect that we will have decreased difficulty with positive margins because of this technology.

Q: Would you recommend LOCalizer to your colleagues? 

A: I would absolutely recommend  LOCalizer to anyone performing lumpectomies.  I think it fills all criteria which are necessary for the exceptional level of care I wish to provide.

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