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Less invasive procedure for biopsies used in Pa.

April 09, 2001

Less invasive procedure for biopsies used in Pa.



By STACEY DANZUSO / Staff Writer, Chambersburg


CHAMBERSBURG, Pa. - As doctors worldwide work to come up with more effective and efficient ways to treat the mounting cases of breast cancer, a local surgeon has brought one of those latest advancements to the new Summit Health Center.

Dr. James E. Hurley, medical director of the Rhonda Brake Shreiner Women's Center at the new health center on Norland Avenue, and a practicing partner of South Central Surgery Associates, got the go-ahead in January to begin Sentinal Node Biopsy on his patients with breast cancer.

Hurley, who has been practicing in Chambersburg for 14 years, is the first in the region to offer SNB, a less invasive and more cosmetically appealing option to a traditional biopsy, he said.

In the past, when a woman had a lumpectomy or mastectomy, 10 to 20 lymph nodes under the arm were also removed, causing pain, swelling and longer recovery periods.

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With the sentinal node procedure, Hurley removes the two or three nodes closest to the cancer, cutting recovery time and limiting discomfort.

"We can take two or three nodes and get the same information as 10 or 20," he said. "They are first in line to pick up cancer. If those nodes don't have cancer in them, you can assume the upper ones don't have cancer."

Blue radioactive dye is injected into the patient and the nodes are removed in about an hour on an outpatient basis.

With the number of cases of breast cancer expected to double to 420,000 by 2020, Hurley said moving ahead with new procedures is necessary.

Hurley, 44, said he became interested in the procedure about three years ago when he and a group of surgeons traveled to the University of South Florida and studied their research.

Upon their return, the Chambersburg Hospital Institutional Review Board approved a study. Hurley is the first locally to complete the first phase and move on to performing SNB on a regular basis.

He has performed four since January and has others scheduled.

But before he could get his current approval, Hurley had to perform more than 25 biopsies and take out all of the nodes to show he could correctly identify the sentinal nodes and that he could get the same information from just them.

"You had to do that to make sure you're getting all of the right information," he said.

Hurley joined a study at the University of Louisville and was one of 200 surgeons supplying information on more than 1,000 patients.

"We found we were getting the same information from just the sentinal nodes as all of the lymph nodes," he said.

While he has had success with all of his patients, Hurley said the procedure is not for all women.

There is a lengthy list of medical conditions - ranging from pregnancy to prior cancer - that disqualify some women from opting for Sentinal Node Biopsy, Hurley said.

But for most women, SNB will become the common treatment in the future.

Given its success, more and more surgeons will learn the procedure, but Hurley said it will take them time to build a track record.

Sentinal Node Biopsy is only one of several breast-cancer detection or treatment options on the way.

Magnetic resonance imaging to check for breast cancer, computer-assisted readings of mammograms and ductal lavage are next in line.

Summit Health Center already offers stereotactic biopsies.

Hurley began performing stereotactic biopsies several years ago. Like SNB, the stereotactic biopsy is less invasive for women and involves the insertion of a needle into the breast to determine if a lump is cancerous.

The alternative is an open biopsy that involves an inch-long incision.

"I'm very pleased. This is exciting that the women's center is trying to push the envelope," Hurley said.

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