Tidelands Health Breast Health Program has the distinction of being one of the only nine in South Carolina, and the only one in the Grand Strand region, to earn accreditation from the National Accreditation Program for Breast Centers (NAPBC). The program prides itself in maintaining a leading position in the fight against breast cancer, and two of its top surgeons took a moment to reflect and share their thoughts on the trends and new technologies that are redefining breast cancer treatment.
Dr. Craig Brackett, Medical Director of Tidelands Health Breast Health Program, began the discussion with his observations on the recent shift in the biology of breast cancer.
“We’re seeing more breast cancer cases due to obesity,” the surgeon stated. “We’ve also seen a shift from the slow-growing, post-menopausal breast cancers to the more aggressive Triple-Negative or Luminal B type cancers. We also know statistically now that there’s no difference between Caucasian and African-American women in their incidence of breast cancer.”
Because of the fast-paced, continually-evolving nature of breast cancer, Tidelands Health keeps pace through participation in the South Carolina Surgical Quality Initiative. This program is a quality collaborative to increase positive surgical outcomes in the state.
Dr. Angela Mislowsky, a Breast Surgeon for Tidelands Health, explained some of the benefits of this program.
“Several hospital systems in the state have come together, with everybody looking at a different part of a surgical outcome. Each hospital system is looking at their own data and sharing it with everybody else, so we can improve on reoperation rates, whether it’s from colon cancer, a gallbladder surgery or breast cancer surgery. It’s a collaborative effort to share ideas and techniques that can make us all better at specific specialties.”
New Tools in the Fight Against Breast Cancer
Tidelands Health Breast Health Program also refines and improves surgical outcomes through the latest technological developments such as MarginProbe. MarginProbe determines if a proper threshold of tissue (known as a safe margin) has been removed around a cancerous tumor. This is important to avoid the need for a patient to have additional surgeries to ensure that all cancer is eliminated (known as re-excision).
“Re-excision rates in the country have always been a big issue, considering that after a primary lumpectomy the rate could be as high as 40 percent in the past,” Dr. Brackett said. “So there has been a push to try and come up with different devices to cut that figure down. I was actually at a breast cancer conference about seven years ago, met representatives from MarginProbe, looked at their data and then approached our hospital about purchasing the device.”
The surgeon explained how he uses MarginProbe in the operating room (OR).
“When we excise the tumor, we orient it right there on the table,” he said. “Then we do a MarginProbe evaluation, we ink the specimen and then x-ray two different views. If I see the tumor is close to one of our inked margins, I will remove additional tissue right there. This is how we can assess margins intraoperatively.”
Dr. Mislowsky added how she uses MarginProbe in the operating room.
“I use it on every appropriate breast cancer patient”, the surgeon stated. “The goal of a tool like MarginProbe is to take less tissue, but still be confident that I will not need to go back and take more later. Basically, with MarginProbe, I’ve learned to trust the data.”
Patients can be very engaged in their own care
“And my patients are very interested to hear about MarginProbe,” Dr. Mislowsky continued. “I’ve had several go home and research the device, and then come back with questions, because they are really paying attention to what you’re doing. I tell them how we take out the tissue in the operating room and we deploy this little device that uses radio frequency waves and it tests the edges of the cancer. I tell them that I pay attention if the device tells me it thinks there might be some cancer cells left. That makes patients feel more comfortable that we’re proactive in the operating room to keep them from having to come back for another surgery.”
Dr. Mislowsky has found that her positive margin rate using MarginProbe has dropped 52 percent and the surgeon feels that it’s a tool that helps her make the best decisions possible for her patients.
“In surgery, we like to think we’re perfect but it’s an imperfect process,” the physician explained. “We have to use our best judgment, and MarginProbe helps give us more confidence that we’re making the best judgement possible. It’s the biggest thing that we’ve brought into our operating room since I’ve been here.”
Craig Brackett III, MD, FACS
Dr. Brackett is the co-chair of the Tidelands Health Breast Health Program Leadership group; he and a multi-disciplinary group of providers and administrators set the standards of care within the health system based on established national standards.
- American Society of Breast Surgeon Member
- American Society of Breast Disease Member
- American College of Surgeons Oncology Group Member
- Education: Medical University of South Carolina
- Residency: Medical College of Georgia Hospital and Clinics
- Internships: Medical College of Georgia Hospital and Clinics
Angela Mislowsky, MD, FACS
During Dr. Mislowsky’s internship and residency at Union Memorial Hospital, she was a member of the hospital’s patient care advisory committee and the recipient of both the Viresh Patel Award for outstanding work at the intern level and Union Memorial’s Best Research Award. At the University of Pennsylvania, where Dr. Mislowsky completed her breast surgery and breast cancer fellowship training, she conducted research in the field of breast cancer. She is currently active in research and is a published author of articles on breast health.
- American Society of Breast Surgeons
- American College of Surgeons
- Society of Surgical Oncology
- Association of Women Surgeons
- Education: New York Medical College
- Internship: Union Memorial Hospital
- Residency: Union Memorial Hospital
- Fellowship: The Hospital of The University of Pennsylvania, Breast Oncology and Surgery
Tidelands Health is the largest health care provider in Georgetown, Horry and Williamsburg counties. With three hospitals and more than 50 outpatient locations that stretch from Andrews to North Myrtle Beach, Tidelands Health is helping people across the Tidelands region live better lives through better health.
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 Dilon.