Top Hospitals and Healthcare 2016: New early stage breast cancer surgery and radiation at UVA.
Drs. Tim and Shayna Showalter.
When Ann Deaner’s breast cancer returned after 11 years in remission, she was told she had two choices: a mastectomy, or a lumpectomy followed by four to six weeks of daily radiation. “Neither one of those choices made me feel good,” says Deaner, a retired teacher from Winchester. An article given to her by a friend on intraoperative radiation led her down a new path. She says she soon was referred to “a couple who were on the cutting edge, and were just starting a brand new clinical trial.”
In December 2013, Deaner became one of the first participants in the Precision Breast Intra-Operative Radiation Therapy (IORT) clinical trial at the UVA Cancer Center, a National Cancer Institute-designated center. The procedure was developed at UVA by a team led by breast surgeon Dr. Shayna Lefrak Showalter and her radiation oncologist husband, Dr. Timothy Showalter.
According to Shayna Showalter, the procedure offers a safe and convenient option for women with early stage breast cancer who have not received prior radiation to the same breast. With Precision Breast IORT, a lumpectomy—the partial removal of a breast—and radiation are combined in a single visit. The procedure takes place in UVA’s unique brachytherapy suite and lasts about two hours. No follow-up radiation visits are required, pending good pathology results.
The patient, under general anesthesia, first undergoes surgery, then a brachytherapy catheter is placed in the breast and scans are taken using CT imaging. This in-room imaging differentiates the procedure from other types of IORT, which have been around for about 10 years.
“The CT scan allows the radiation oncologist to figure out an individualized treatment plan, so they can sculpt the radiation dose away from the skin and the heart and the chest wall,” the surgeon explains. “Those are areas that do not need radiation and can actually be harmed by it.” The radiation is delivered by a multi-lumen catheter and is highly focused on target areas. “It’s about double the dose of radiation as other forms of intraoperative radiation,” says Shayna Showalter. A total of 86 patients have been treated at UVA so far. Candidates for the trial are women over the age of 45 with early stage breast cancer—tumors less than 3 centimeters in size with no lymph node involvement.
After Deaner had her lumpectomy, the doctors discovered some invasive cells in the mass that was removed. Further testing, however, revealed that the cancer had not spread to her lymph nodes. She returns to UVA for regular follow-ups, and maintains a healthy diet and exercise routine. Three years following her surgery, her mammograms remain clean.
“I feel like I got the best of the best,” says Deaner, of the Showalters and their team. “I can’t say enough about the quality of care they provided.” Cancer.UVAHealth.com
Cancer News
In September of last year, Bon Secours Hampton Roads broke ground on a new medical plaza at its Harbour View campus. The $20 million project will construct a new 58,000-square-foot facility offering comprehensive outpatient care, including radiation and chemotherapy, to cancer patients in the community.
Last summer, Dr. Randal J. West performed Johnston-Willis Hospital’s first hysterectomy using the da Vinci Xi robotic surgical system. Dr. West is one of only two surgeons in Central Virginia to have performed more than 1,300 robotic procedures, which allow doctors to treat women for cervical, uterine and ovarian cancers using minimally invasive technology.
Starting in January 2016, LewisGale Regional Health System began offering 3-D mammography at the LewisGale Breast Center in Salem. This process has been shown to detect 40 percent more breast cancers, particularly in individuals with denser tissue. Having this technology will allow the center to better serve the community and aid in early detection of cancers in women and men.
Nicholas Farrell, a chemistry professor at Virginia Commonwealth University and a member of the Developmental Therapeutics research program at VCU Massey Cancer Center, is studying the anti-metastatic effects of platinum-based drugs used to treat cancer. His findings were published in August in the journal Chemical Science.
Cancer Top Honors 2016
Virginia Hospital Center Arlington, VirginiaHospitalCenter.com, 703-558-5000 Inova Loudoun, Inova.org, 703-858-6000 Novant Health/UVA Health System Prince William and Haymarket, NovantHealthUVA.org, 703-369-8000 Martha Jefferson Hospital Charlottesville, Sentara.com/Charlottesville-Virginia, 434-654-7000 Martinsville Memorial Martinsville, MartinsvilleHospital.com, 276-666-7200
See all of our top hospitals for 2016, below.
Cancer LewisGale Regional Cancer Center Cardiology VCU Pauley Heart Center
Dermatology Inova Melanoma and Skin Cancer Center
Diabetes EVMS and Sentara Heart Hospital
Gastroenterology Centra Lynchburg General Hospital
Geriatrics Riverside Center for Excellence in Aging
Neurosurgery Bon Secours St. Mary's
Orthopaedics Carilion Clinic
