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Carroll Hospital first in state to adopt less invasive new breast surgery technology

Dr. Dona Hobart, medical director of the Center for Breast Health at Carroll Hospital, has performed about 20 surgeries since the start of 2018 using LOCalizer, a system that uses radio frequency identification tags to locate small tumors within breast tissue.
Dr. Dona Hobart, medical director of the Center for Breast Health at Carroll Hospital, has performed about 20 surgeries since the start of 2018 using LOCalizer, a system that uses radio frequency identification tags to locate small tumors within breast tissue. (Amy Davis / Baltimore Sun)

Carroll Hospital is the first hospital in Maryland to adopt a new technology for breast surgery that improves patient comfort and makes that surgery easier for surgeons.

That's according to surgeon and medical director of the hospital's Center for Breast Health Dr. Dona Hobart, who pushed for the hospital to adopt the LOCalizer, a system produced by Faxitron that uses radio frequency identification tags to locate small tumors within breast tissue. A small pencil-like receiver allows Hobart to home in on the tumor with greater accuracy than can be done using other methods.

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"It will say, you are 2.2 millimeters away or you are 5 centimeters away. That's what's really beneficial," she said. "Then you can measure how much you want to take out based on how far away you are from the tag."

The need for this type of solution comes from the success of modern mammography, which Hobart said can now identify tumors in breast tissue that are too small to feel. Once confirmed in a biopsy, those tumor must be marked in some fashion so that a surgeon like Hobart can remove them and just the necessary amount of tissue around them.

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LOCalizer from Faxitron is a way to guide breast surgeries easily and accurately now being used at Carroll Hospital, the first hospital in Maryland to use the new technology.
LOCalizer from Faxitron is a way to guide breast surgeries easily and accurately now being used at Carroll Hospital, the first hospital in Maryland to use the new technology. (Courtesy Faxitron)

"Historically what we used to do was use a wire to localize those," she said. "They would have a wire put into the breast, which would stick out of the skin. Then they literally used to stick a Dixie cup on top of it to protect the wire — awkward, not pleasant, painful."

That's a procedure that's still being used in many hospitals, Hobart said, though Carroll Hospital phased it out in 2014 in favor of what was called radioactive seed localization.

"We were the first people in the state of Maryland to get it. That we used a little tiny radioactive iodine seed to localize these tumors," she said. "They are the same seeds used to treatment prostate cancer, but when they treat prostate cancer, they use 150 of these things. We used one."

This had many advantages, according to Hobart, primarily sparing the patient the discomfort of having a wire implanted in their breast. The seeds could also be implanted up to five days ahead of time, so that surgery and the marking of the tumors need not take place on the same day.

"It was great," she said. "But like everything, it was great then and now there is new stuff."

Each LOCalizer emits an individual signal, allowing accurate mapping of multiple tumors if necessary, Hobart said, whereas the seed's radioactive signal simply registered more or less strongly on a handheld Geiger counter.

"I equate the seeds to like when you are saying, 'You're hot,' or, 'cold,' " she said. "This is like giving you GPS coordinates."

And while the seeds did not emit enough radiation to be dangerous, according to Hobart, they were highly regulated and could not be left in a patient for more than five days.

"This thing can be put in up to 30 days ahead of time and pretty soon it will be able to stay in forever if need be — if it gets put in and a patient gets a cold and we have to delay their surgery, it's not tragic," Hobart. "With the seed, we had to get it out."

Hobart has performed about 20 surgeries since the start of 2018 using the new technology, something made possible, she said, due to funding through the Carroll Hospital Foundation; the LOCalizer, at least for now, is more expensive than other techniques.

"We are really fortunate here because our foundation provides support for things that are really good for the patients," she said.

And while Carroll Hospital is the first in the state to use this new surgical technique, Hobart is certain it is the next big thing in breast cancer surgery.

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"I think it's going to take off," she said in an interview Thursday. "I had correspondence with a surgeon in the Netherlands just yesterday asking me about it."



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