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New lumpectomy technique puts breast cancer patients' comfort at the forefront

Through the use of innovative technology new to Avera Health, breast cancer patients need not have a long wire hanging from their breast ahead of tumor removal procedures.

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Dr. Chris Vogl, a surgeon with Avera Health in Mitchell, talks with Sister Marita Pfau, a breast cancer survivor, while holding a SAVI Scout device.
Nathan Johnson / Avera Health
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MITCHELL, S.D. — It was this past May when Sister Marita Pfau first noticed an unusual indentation on her breast during a self-exam.

“I happen to notice that in the mirror, whether I had my arm up or down, it didn't matter with the indentation,” Pfau said. “That made me go get a mammogram.”

After a late-May mammogram discovered an unusual mass in her breast, a June 1 biopsy confirmed it. Breast cancer.

Dr. Chris Vogl, a second-year surgeon at Avera Queen of Peace in Mitchell, South Dakota, said Pfau’s cancer was in stage 1, which means there had been no spread to lymph nodes.

Though any form of cancer is a scary diagnosis, an analysis of U.S. patient data conducted by the United Kingdom-based Institute of Cancer Research found that from 2005 to 2011, 89% of patients diagnosed with any stage of breast cancer survived at least five years after their diagnosis. A similar analysis from the American Cancer Society from 2011 to 2017 found that patients diagnosed with localized breast cancer — or cancer that hasn’t spread — had a 99% five-year survival rate.

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Pfau, an 81-year-old nun living in western Mitchell, admitted that while she didn’t fully understand everything the doctors told her, she trusted that she’d receive the best care possible.

“I just put my hands in their hands, and with the Lord, of course, that I just trusted that the doctors know what they're doing and they'll do the best they can to help me,” Pfau said.

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Sister Marita Pfau, a breast cancer survivor, stands with Dr. Chris Vogl, a surgeon with Avera Health, with a SAVI Scout device between the two of them.
Nathan Johnson / Avera Health

An innovative, patient-focused approach

In July, Avera’s Mitchell campus received the SAVI Scout, an innovative piece of medical technology that’s changing how doctors approach and how patients experience procedures to remove early-stage breast cancer.

Before the arrival of the SAVI Scout, patients in need of a lumpectomy — a procedure that removes a portion of the breast surrounding a tumor rather than the entire breast — would have a wire implanted in their breast, which sometimes would have to hang out for hours on end.

“The old way of doing it is radiology would put a long wire through the skin in the breast and the end of that wire would be in the center of the tumor, and then they leave that wire in place,” Vogl said. “For me in the operating room, I can follow that wire down as a roadmap, look for the end of it, and that's how I found the tumor in the past.”

“The downside to that is the patient goes to radiology, they get this wire put in place and they have to leave it in place. Then they go back to the pre-op area, and they can be there for several hours waiting for the surgery to start,” Vogl continued. “They have this long wire just hanging out of their breast, which is uncomfortable and painful, and it's just not the best patient experience.”

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A reflector the size of a grain of rice is placed into a tumor, which is then located by a surgeon with a SAVI Scout device for removal.
Contributed / Avera Health

The SAVI Scout avoids using the wire completely. Instead, radiologists will place what Vogl referred to as a seed, roughly the size of a grain of rice, in a patient’s tumor. Because the seed is implanted, Vogl said patients don’t notice it’s there, and could have it inside their tumor for months before a surgery, if necessary.

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Though the seed isn’t radioactive, and doesn’t harm the patient if it’s left in for extended periods, Vogl compared the SAVI Scout device to a Geiger counter.

“It's a little probe that activates that seed with special light and it helps me find where that seed is in the breast in the operating room so I know where the tumor is and I can go out and take that tumor out,” Vogl said.

Though using the SAVI Scout to remove a tumor from the breast isn’t necessarily any less invasive than the wire method, Vogl said it provides the patient with more comfort and the same outcome.

Pfau was the first patient at Avera Queen of Peace in Mitchell to receive treatment with the innovative device. She said she “kind of” understood what would be different, but was mostly glad she wouldn’t have to deal with a wire.

“I had kind of an understanding,” Pfau said. “I think I just knew that it wasn't going to have that wire sticking out, you know? And it sounded like a good deal.”

Since her operation with the SAVI Scout, Pfau is cancer-free.

“I'm just glad we got it that early, that [the cancer] was [discovered] in advance,” Pfau said. “I’m just really glad about that.”

SAVI Scout devices are in use at Avera Health systems in Aberdeen, Mitchell, Pierre and Sioux Falls, South Dakota, as well as in Marshall, Minnesota.

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When are mammograms, self-exams necessary?

Pfau said one of her biggest regrets was skipping annual mammograms, which the American Cancer Society encourages women 45 and older receive every year.

After graduating from high school, Pfau earned her four-year nursing degree in Bismarck, North Dakota, and taught her niece how to conduct self-exams, which most health care organizations recommend are done monthly.

Yet, Pfau admits she lacked in those areas, herself.

“I was negligent in having a mammogram for nine years because I was worried about my bones after I had bilateral hip surgeries,” Pfau said. “When I saw that indentation [on my breast], I did feel a spot there, too, and I thought ‘Oh, here we go.”

For those who may have trouble making it to a hospital or clinic for a mammogram, Avera offers traveling 3D mammograms throughout the Dakotas, Minnesota, Iowa and Nebraska. Anyone seeking more information can check out Avera’s webpage on mammography or call 888-667-6928.

A South Dakota native, Hunter joined Forum Communications Company as a reporter for the Mitchell (S.D.) Republic in June 2021. After over a year in Mitchell, he moved to Milwaukee, where he now works as a digital reporter for Forum News Service, focusing on regional news that impacts the Dakotas, Minnesota and Wisconsin.
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