Surgeon Explains the Importance of Preserving the Breast During Cancer Treatment through Education, the Latest Technology—and an Artistic Touch

By Oct 23, 2019 November 5th, 2019 News, Surgeon Spotlight

Image courtesy of Virtua Health

Dr. Elizabeth Revesz has a unique background as an artist and sculptor. She was able to translate her precision, and her ability to see things in three dimensions, into a highly successful career in medicine. But once in the medical field, Dr. Revesz went further to find her true calling. “Medicine is great, but surgery is actually where I feel the most comfortable,” the physician shared. “And I found out that breast cancer is one of those professions where you actually cure people. You take the cancer out; you solve a lot of problems and this profession gives you the most rounded experience because you get to connect with and support your patients in a very difficult time of their lives. It’s a long-term relationship and it’s very rewarding.” 

Dr. Revesz went on to explain why she is proud to work with an organization, Virtua Health, that stays at the forefront of breast cancer treatment in areas such as genetic testing, oncoplasty (cosmetic procedures that can preserve the appearance of the breast post-surgery), and preventive therapy. “Breast cancer is very personal,” she said. “It’s one of those diseases where a patient can survive it, but they will have to deal with the aftermath. Patients might not mind a scar on their back, but when it’s on their breasts, it’s very different. That’s why we take a comprehensive approach and include everything from early detection to minimally invasive surgery with cosmetic procedures to make those after-effects as minimal as possible.”

Dr. Revesz and Virtua are testing every new treatment from hidden scar surgical techniques to genetic modelling to profile risk to new data on drugs such as Tamoxifen. Dr. Revesz is particularly excited about the fact that Tamoxifen can be used as a chemo-based preventive therapy at much lower doses than what was previously thought possible. Virtua also demonstrated their forward-thinking approach to breast cancer care when they became one of the first organizations in the state of New Jersey to adopt MarginProbe, a tool to ensure that all cancer is successfully removed during a lumpectomy procedure, as part of their regular practice.

MarginProbe® is an Extra Layer of Defense to Reduce the Need for Additional Surgeries

“I, along with the other breast surgeons at Virtua, started using MarginProbe to provide an extra layer of protection for patients,” the surgeon shared. “I feel that it’s very important to achieve the best results possible, and to do that means I do not want to remove too much tissue, which could needlessly disfigure a patient. Therefore, I need negative margins, and that’s what MarginProbe helps to provide.”

A negative margin means that a layer of tissue surrounding a removed tumor does not show the presence of cancerous cells. That’s the best way to prevent a patient from needing to go back for an additional surgery if there is any suspicion that cancer could still remain after surgery. MarginProbe is used to scan the margins during the surgery to remove the minimal amount of tissue possible, while still protecting the patient’s health.

“The surgeons here are very proficient with MarginProbe, and it’s very easy to use,” stated Dr. Revesz. “And by providing that extra layer of protection for patients, we can limit additional surgeries with their added complications, from anesthesia risks to damaging prior cosmetic procedures. Even without those harmful effects, it’s still very beneficial to reduce the stress and the emotional roller coaster of a patient not knowing what’s going to happen next. After a lumpectomy, many patients don’t want to face the next step of a full mastectomy and neither do we.”

As a relatively new user, Dr. Revesz has utilized MarginProbe in 20 lumpectomy surgeries to date. Of those 20 patients, only one needed a 2nd surgery due to a positive margin, which the surgeon felt was unavoidable due to malignancy extending into the skin. This makes Dr. Revesz’s re-excision rate far below the national average of 20-25%

But to take a step back from the numbers, Dr. Revesz highlighted the personal impact that a tool such as MarginProbe can have on patients. “I recently had a 38-year-old patient—and it was just a shock to see how young she was and there was no family history of breast cancer, no genetic mutation, or anything else. She had developed breast cancer and had to go through numerous biopsies. As we approached the surgical stage, I really wanted to do the best job possible.”

“When I operated, I was able to utilize hidden scar techniques, and I used MarginProbe to identify negative margins,” she continued. “Plus, I verified that she had no lymph node issues when it was over. Today I saw her in the office and I had tears in my eyes because I was so happy for her that she did so well.”

Staying ahead of the treatment curve

Looking ahead, Dr. Revesz and Virtua are pursuing additional accreditations in hidden scar and oncoplastic programs. They are also going to move to seed localization and away from wire localization, as the practice feels that it is much more comfortable for patients while still effectively helping surgeons locate the tumor to be removed. They are even launching into specialty areas such as treatment of breast-feeding complications to provide a well-rounded approach to breast care.

“Our goal is to attain as much knowledge as possible to help our patients,” Dr. Revesz declared. “We’re looking forward to the San Antonio Breast Cancer Symposium, which I attend every year. Breast cancer treatment is always reinventing itself and I’m always excited to explore each new development and opportunity as it arises.” 

Dune Medical is excited to join Dr. Revesz and thousands of other healthcare professionals at the 2019 San Antonio Breast Cancer Symposium (SABCS) on December 10-14 to review the latest research in the prevention, diagnosis, and therapy of breast cancer. The Smart Biopsy device, funded by the prestigious Horizon 20/20 grant, will showcase its first in man clinical data as one of those technologies capable of helping to reinvent breast cancer treatment.

Elizabeth Revesz, MD

Dr. Elizabeth Revesz is a fellowship-trained breast surgeon. She specializes in the diagnosis and treatment of breast abnormalities and high-risk breast cancer.

Specific specialties:

  • Breast Biopsy
  • Breast Disease
  • Breast Surgery
  • Inverted nipple breast surgery
  • Non-cosmetic breast surgery
  • Cosmetic breast surgery
  • Breast cancer evaluation
  • Breast cysts
  • Precancerous breast lesions
  • Breast lesions
  • Breast lumpectomies
  • Breast lymph node mapping
  • Needle localized biopsy
  • Penn Medicine Virtua Cancer Program
  • Stereotactic Breast Biopsy
  • Virtua Breast Navigation

Education:

  • McGraw Medical Center of Northwestern University
  • Rush Medical College of Rush Univ
  • Saint Joseph Hospital Northwestern University
  • Saint Joseph Hospital Northwestern University

Virtua Health

Virtua Health is committed to helping the people of South Jersey be well, get well, and stay well by providing the complete spectrum of advanced, accessible, and trusted health care services. Virtua’s 14,000 colleagues provide tertiary care, including a renowned cardiology program, complemented by a community-based care portfolio. In addition to five hospitals, two satellite emergency departments, and more than 280 other locations, Virtua brings health services directly into communities through home health, rehabilitation, mobile screenings, and its paramedic program.

Virtua has 2,850 affiliated doctors and other clinicians, and its specialties include orthopedics, advanced surgery, and maternity. Virtua is affiliated with Penn Medicine for cancer and neuroscience, and the Children’s Hospital of Philadelphia for pediatrics.

As a not-for-profit, Virtua is committed to the well-being of the community and provides innovative outreach programs that address social challenges affecting health, from addiction and other behavioral issues to lack of nutritious food and stable housing. A Magnet-recognized health system ranked by U.S. News and World Report, Virtua has received many awards for quality, safety, and its outstanding work environment. For more information, visit ThisIsVirtua.org. To help Virtua make a difference, visit foundation.virtua.org

Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of Dune Medical.