Cutting Edge Technology Goes Beyond Mammography

Nyack - Nyack Hospital is among the first in the world to implement a newly approved, highly sophisticated diagnostic tool in the fight against breast cancer.

The new breast MRI biopsy device enables radiologists to target breast lesions that traditional mammograms or ultrasounds may not be able to detect. And biopsies can be performed at an earlier stage than before.

The device was purchased for use by the Union State Bank Cancer Center at Nyack Hospital's breast imaging team in association with Hudson Valley Radiology Associates. It is the only such device currently available in Rockland, Westchester Orange, and Putnam counties, according to Peter Kwintek of MRI Devices Corp. of Waukosha, Wisconsin, manufacturer of the device. The device received FDA approval last year.

"It's a very exciting technology. It's on the cutting edge. To date, we've only sold approximately 50 of these devices worldwide. I think it's pretty impressive that a community hospital like Nyack Hospital is forging ahead with this, " said Kwintek.

Dr. Evan M. Kaminer, director of MRI, explained that this sophisticated equipment "removes a major barrier in breast MRI acceptance. Before, although you could see something suspicious on an MRI, you could not biopsy it or pinpoint it for surgical removal. The patient's only choice was to come back in six months to see if the lesion had changed and determine whether it required exploratory surgery."

"Now, once we view a suspicious lesion on a breast MRI, there are two options," he said.

"Using a needle to take a sample of the lesion, the radiologist can perform a core biopsy. Our pathologists can then determine whether or not the sample is malignant. It also allows us to accurately stage patients who know they have cancer so we can determine whether they require a lumpectomy or a mastectomy," he said. The core biopsy procedure takes about a half hour and the patient goes home right afterward.

For patients about to undergo surgery, "we can pinpoint the tumor by putting in a localizing wire for the surgeon so that the patient can have an immediate lumpectomy or surgical breast biopsy," he said.

Thanks to the cancer center's team approach, in either case biopsy results from the pathology department are generally available within 24 hours, shortening the stressful waiting time.

The MRI breast biopsy is performed with a patient lying on her stomach in the MRI machine. The breast rests in the biopsy coil and gentle compression is applied. A small amount of MRI dye is injected via the arm, which enables the radiologist to obtain a series of images used to target the suspicious lump. Only a local anesthetic is needed to make the patient comfortable. A core biopsy can be performed with a needle or by localizing the lump with a wire for surgery.

A traditional mammogram is still the primary diagnostic tool for detecting breast cancer.

"MRI biopsy is used primarily in high-risk patients, those with mammographically dense breasts, a strong family history of breast cancer or those who carry the BRCA gene for breast cancer," said Kaminer.

The cancer center's highly-credentialed radiology staff are experts in their field, having completed fellowship training in either Magnetic Resonance Imaging (MRI) or Breast Imaging. The cancer center offers a full range of diagnostic breast imaging tests.

"I have been performing breast MRI for six years. We have superb technology that allows us to obtain detailed images of the breasts," said Kaminer. "The only thing we have been lacking is a way to biopsy what we find. I have been waiting patiently for this new device and am very excited about the benefit it will offer the women in our community."

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Article provided by Hudson Valley Business Journal- SPECIAL REPORT