MILFORD — Knowing the pain that breast-cancer patients are forced to endure, both physically and emotionally, Dr. M. Lisa Attebery of Bayhealth Hospital, Sussex Campus in Milford, is pleased that she has helped find a way to alleviate much of their discomfort.
Dr. Attebery, a fellowship-trained breast surgical oncologist, has brought the world’s only platform for both wire-free localization and radiation-free sentinel lymph node biopsy to Kent and Sussex counties — Endomag’s innovative Sentimag system.
Dr. Attebery has been using the system to locate and remove cancerous tissue without the use of a guidewire into the patient’s breast during surgery, as has been the standard breast cancer treatment method.
It has proven to be a valuable new tool for Delawareans battling breast cancer. She averages between 10 to 15 surgeries per week.
“The majority of breast cancers are nonpalpable, meaning that they’re found on a mammogram ultrasound and so the old standard was you’d have a mammogram, you’d have a biopsy and then when you would go into the operating room,” Dr. Attebery said. “Now a couple of things have happened. Number one is the patient would actually have to go to radiology and have a guidewire placed into their breast, which as one can imagine is not fun and not comfortable on many emotional and physical levels.
“In addition to that, whenever we have an invasive cancer for breast, we would like to touch the lymph nodes and the way that had been done previously was two injections, in addition to going to radiology for a (guide)wire. They also go to radiology again and a radionuclide is injected into the breast as well.
“Then they would go to the operating room and the surgery would be completed. So, not only is it painful for the patient, you’ve got exposed to a radionuclide. Patients just didn’t like it because it was so long.”
Embracing new technology
That’s why Dr. Attebery has been utilizing the Endomag Sentimag system for the past couple of years.
Called the Magseed marker, the magnetic seed is smaller than a grain of rice and can be neatly placed to mark a tumor weeks or months ahead of its removal. This is because the seed is specially designed so that it does not move, and women treated with it only stand a 6.5% chance of needing to return to surgery.
It involves implanting the small Magseed device in the breast or injecting Magtrace in the operating room days or weeks before surgery, making it convenient for patients. It also avoids the radioactive material and blue dye that has been traditionally used as a tracer.
The Sentimag probe works like a metal detector. When placed near the skin’s surface, it can detect the Magseed or Magtrace. By accurately determining cancer spread or tumor stage, this method is beneficial in guiding a patient’s treatment plan, and in some cases could potentially mean avoiding a more invasive surgery.
Dr. Attebery said the tracer is designed to follow the route cancer cells are most likely to take when they spread through the lymphatic system.
“This enables me to precisely pinpoint cancerous nodes and perform a more targeted dissection while preserving as much healthy tissue as possible. It also gives patients a more flexible and comfortable experience without radiation exposure,” said Dr. Attebery. “The Magseed removes the need for painful wire localizations to find non-palpable breast cancers.
“It can be targeted when the patient is asleep using the Sentimag machine, avoiding a trip to the Radiology department, an additional mammogram, the wire and wasted time for the patient at the hospital. This is a transformational approach in treating breast cancer. Making this available to patients in our community is very gratifying.”
It also makes Dr. Attebery a pioneer in her field, as she is among the first doctors in the United States using the revolutionary breast cancer treatment.
She said that with the Sentimag machine, she can perform the breast surgery by herself — there is no need for radiologists or nuclear med techs.
“A patient comes into my office with a biopsy, and I can drop a Magseed, which is magnetic and emits a signal,” she said. “So, the morning of surgery or in my office, I can either inject the liquid Magtracer, the patient comes in for surgery, no needles, no wires, no nothing and goes immediately into surgery.
“So, they’re not tormented by a wire sticking out of their breasts. They go to sleep. I have a Sentimag probe that tells me exactly where to identify the specific lymph node, which is very important, called the sentinel lymph nodes.
“In addition, I could put the Sentimag on the breast with the machine and the probe and identify where my marker is and be able to make my incision, do my surgery, all at once, and so it really has changed the whole gamut of breast surgery.”
Dr. Attebery said that one in five women with breast cancer who have surgery have to go back under the knife, because their cancer wasn’t completely removed.
That’s because the traditional method of marking tumors for surgery is to insert a long wire into the site of the cancer. This wire can move before surgery, which means that surgeons risk missing cancerous tissue.
“It really probably is the first innovative new technology for breast cancer surgery that’s come along since probably nipple-sparing mastectomy, which was in the early 2000s,” she said.
At home in Sussex County
Dr. Attebery works primarily out of Bayhealth Hospital, Sussex Campus in Milford but also does some work out of a surgery center in Dover.
“I’m mainly focused at the hospital because they’ve been so great to work with,” she said. “They have my Sentimag machine there and the patients are very happy, which is good.”
Dr. Attebery said she is proud to be among the first breast cancer doctors in America to use the new technology.
“It’s a pretty amazing thing to get phone calls from colleagues all over the country after they start to learn it,” she said. “And it’s also a great feeling to have a patient that has a new breast cancer, or a patient I’ve seen before and they’re like, ‘Please tell me I don’t have to do a guidewire,’ and I’m like, ‘Nope.’
“As a matter of fact, we’re the third place in the country to do it. It’s great. I wish it would catch on even faster. I think some of the rural areas could really utilize it. It’s great to be on the forefront for sure, and just what it provides the patients is phenomenal.”
Her timing was amazing, as well.
She acquired the equipment at the end of 2019 and did her first case in early 2020, just before the COVID-19 pandemic hit. It turned out the new technology was a big help during the pandemic.
“It made it safer and easier. There was less transport throughout the hospital, which was always a concern,” said Dr. Attebery, who began working at Bayhealth Hospital, Sussex Campus in July 2019. “We’re in the COVID era, you know, being exposed. And it allowed me to continue to treat patients.
“We have so many women — 80 percent of women missed their mammograms during that period of time — so the ones that were able to receive their continuity of care just continued on, because they weren’t afraid of coming in. We reassured them they came into the operating room and nowhere else. It was great for them. They didn’t miss anything.”
The doctor has found herself right at home in Sussex County, which she said is much like where she grew up in Ohio.
“I grew up outside of Columbus and so I like the fact that people are nice. It’s a little bit more of a laid-back atmosphere, which is really pleasant,” she said. “It feels like home.”