BioZorb® Implant Side Effects

The BioZorb® is a 3D implanted tumor bed marker created for patients with breast cancer to mark the breast cancer surgical excision site accurately. It consists of a spiral three-dimensional bioabsorbable framework embedded with six permanent titanium surgical clips. The BioZorb® offers 3-dimensional breast radiation treatment targeting and is available in various sizes from 2-5cm, including Lower Profile, and is intended to enhance results in breast-conserving surgery (BCS) when used in early breast cancer stages. Low Profile (LP) is an ideal option for smaller, flatter surgical cavities.

Dr. Gorman is one of the leading breast surgeons that has successfully used the BioZorb® implant in hundreds of Stereotactic Body Radiation Therapy (SBRT) breast cancer surgeries. She has seen firsthand how they improve outcomes with breast-conserving therapy post-surgically.

The BioZorb® implant has many benefits for patients, including excellent cosmetic outcomes, improved accuracy in radiation therapy, and minimal scarring after breast conservation therapy. Many breast cancer patients who have received breast-conserving surgery have experienced the benefits of the BioZorb® implant, though there have been a few reported side effects. This article will discuss some of the side effects reported by patients who have had the BioZorb marker implanted and how the benefits still outweigh any potential risks.

BioZorb® Reported Side Effects

  • Some patients with BioZorb® implants have reported hard, uncomfortable lumps in the area of their implants.
  • Patients have reported skin deformation and scarring of the skin around the devices.
  • Patients have reported skin reddening, irritation, and itching in the vicinity of their BioZorb® implants.
  • Patients have reported that the devices have not been absorbed in the expected time frame but instead have stayed intact for over 2.5 years.
  • Some individuals also claim that the implant is so unpleasant that they want it removed or decide to undergo partial breast reconstruction or a mastectomy to remove the entire breast.
  • Some patients report that the BioZorb® implant causes the affected breast to become noticeably bigger than the unaffected breast.

Do the benefits of the BioZorb® implant outweigh the side effects?

About 60% of the more than 200,000 American women with early-stage breast cancer had a lumpectomy with whole breast irradiation. Since it can be challenging to identify the specific region of the breast where the tumor came from, radiation is often applied to the entire breast. BioZorb® was developed to improve the accuracy of such radiation therapies, and it has done just that.

Six titanium clips on the device show radiation oncologists precisely where to point the radiation beam. Radiation is thus applied to the tissue that needs it the most. The “lumpectomy bed” will then benefit from the boost of radiation. And even though sometimes the whole breast must still undergo radiation treatment, BioZorb® guarantees that the correct location gets the optimal boost dosage. With BioZorb®, Dr. Gorman also has been able to use partial breast radiation with SBRT (BioZorb® as the target). This shortens the course of radiation to five days and has improved cosmetic outcomes.

According to a study in the World Journal of Surgery, of 110 patients using the BioZorb® implant, the marker enabled more precise targeting for radiation planning and treatments in 95.7% of the cases.

Over the course of around two years, BioZorb® is naturally absorbed by the body, but the titanium clips are left in place. As a result, during routine mammography, it is easier for your doctor to precisely analyze the former tumor spot.

Breast surgeons are utilizing an extra advantage of BioZorb® implantation. After surgery, the BioZorb® prosthetic implant aids in preserving the breast’s natural form by supporting the breast tissue. As part of your lumpectomy, the 3-D spiral design of the marker is proving to help reshape the breast, which enhances the breast’s contour and, ultimately, its aesthetic appeal.

Dr. Gorman and BioZorb®

BioZorb® provides breast cancer surgeons with another cutting-edge method to enhance therapeutic and cosmetic results and improve overall patient outcomes. Dr. Gorman believes that for many patients, the benefits of the BioZorb® device outweigh any potential side effects. She continues to perform surgeries with the BioZorb® implant to help more women heal and recover.

If you have questions about the BioZorb® device or breast cancer treatment, please call our office to schedule an appointment. At your consultation, Dr. Gorman will be happy to personally answer all of your questions. Texas Breast Center is committed to providing its patients with a personal, individualized, and targeted approach to breast surgery and breast cancer treatment.


Breast Cancer Recurrence: New Data in 2022

In layman’s terms, breast cancer recurrence happens when cancer has come back after treatment. When a number of breast cancer cells evade initial treatment and later aggregate, they cause the cancer to return despite months or even years of remission. It is important to note that a minimum of a year must pass between the execution of cancer therapy and the appearance of growing cancer cells for the growth to be deemed a recurrence, rather than treatment failure or progression of cancer.

Every survivor of breast cancer faces a chance of recurrence, so it is essential to understand what to look for and how to take proactive measures. We have written a previous article that details risk factors of breast cancer recurrence and many of the prevention and treatment methods used to fight the growth of cancer cells. However, new data has arisen, giving us an even greater insight into the ins and outs of breast cancer recurrence.

New Data

Initially, recurrence was thought to happen within the first five years after treatment. Risk is greatest during these beginning years, but up-to-date studies reveal that the risk of recurrence lasts more than thirty years. Cancer cells can lay dormant, causing them to be undetectable for long periods, leading to a recent notable concern of the risks of late recurrence. The growing concern is attributed to a high cumulative incidence increase (which is an estimate of the risk that one may experience an event within a specific period). This means that more patients are at risk for late recurrence due to an increased number of long-term breast cancer survivors.

While this information seems alarming, and certain factors make recurrence more likely, thankfully, those who have a recurrence are not in the majority, and research has allowed us to identify the most prominent contributors to recurrences. The study also notes that because of the allotted time between the research participants’ first diagnoses and present day, as well as the study’s focus on late recurrence (requiring an extended follow-up), there have been significant changes and improvements in treatment procedures and technology since the participants’ initial treatment. Therefore, the study results are uncertain in association with today’s regimens. Because of this, such studies are paramount and must be completed repetitively to find continual up-to-date results.

Recurrent Breast Cancer

While the chances of a recurrence are not common, it is still valuable to consider the risk factors and to understand the realities of the different types of recurrences.

Types of Recurrence

If a recurrence does occur, a breast surgeon will categorize it by its appearance in proximity to the initial breast cancer. The three forms are:

Local recurrence

  • This refers to when the breast cancer returns to the same chest area as the original tumor.
  • Changes in appearance or feel (such as thickening of the skin or new lumps) are typical indicators of a local recurrence.

Regional recurrence

  • It is deemed regional recurrence if cancer cells show growth in nearby lymph nodes (found in the armpit or collarbone) to the initial cancer area.
  • Regional recurrence is differentiated from local recurrence solely because of the involvement of lymph nodes.
  • Symptoms of regional recurrence may involve newfound pain or lumps in the arm attached to the side of the body with the original breast cancer.

Distant recurrence

  • When cancer has traveled to different parts of the body (such as bone or organs), it is considered a distant recurrence.
  • Another name for this is metastatic breast cancer.
  • Bone pain, weakness, and extreme fatigue may point to metastatic breast cancer.
  • It is considered stage IV cancer, as the cancer has extended to other parts of the body.

Which breast cancer is most likely to recur?

The initial diagnosis is a significant indicator of the chance of recurrence. Recurrent breast cancer is most likely to appear in patients who had an original tumor with more than three positive lymph nodes.

What are the chances of recurrence of breast cancer?

The cumulative incidence of recurrence is between 8.5-16.6% for fifteen to thirty-two years after a primary diagnosis. Chances of late recurrence are typically higher for those whose initial breast cancer was found in the lymph nodes and resulted in tumors over 2o millimeters. The chances are higher for women who were 35 or younger during their primary diagnosis. According to the recent data, 2,595 of the 20,315 women involved in the research study were diagnosed with a recurrence more than ten years following their initial bout with breast cancer.

Is recurrent breast cancer worse?

Recurrent breast cancer may prove more challenging to manage, and the therapy used in your initial treatment may no longer be effective in your specific case. Metastatic cancer may also require more aggressive treatment, as the cancer has spread to more than just one part of your body. Recurrent breast cancer should not automatically be considered worse than the primary diagnosis, but it will often require different methods of treatment or therapy.

Treatment

Even simple cells can become tumors if not adequately treated. It is impossible to guarantee a 100% chance of freedom from cancer recurrence. Still, treatment may be able to halt the growth of undetected cells for many years, and there are methods of prevention that the doctor-patient duo can take to reduce your risk of recurrence.

While a breast cancer diagnosis can seem bleak, both Dr. Gorman and the researchers of this recent study recognize the significant evolution of modern-day regimens and their success rate. If your breast cancer comes back, treatment is available. Depending on the type of breast cancer, treatment may entail surgical treatment and radiation therapy. More aggressive treatment regimens and therapy approaches may be merited for those at a higher risk of late recurrence. Survivors are also encouraged to stay under extended surveillance by making regular check-ins with their doctors and surgeons.

Risk Factors and Therapy

The chances of recurrence are significantly lowered by the proactive utilization of hormone, chemo, or radiation therapy following the initial removal of cancer cells. You can play a role in lowering the recurrence risk factors by opting for therapy options (such as radiation treatment or endocrine therapy) recommended by your oncologist. Such regimens may attempt to prevent breast cancer recurrence or aid in reducing the potential of recurrence. Exercise and a healthy diet are also easy, proactive measures to implement for holistic well-being and to reduce the risks of recurrence.

Dr. Gorman and Texas Breast Center

Remember that recurrent breast cancer is not your fault. Though a breast cancer diagnosis can be alarming or dismaying, Dr. Gorman holds fast to the fact that “treatment for breast cancer has improved significantly over the last few years, and success rates continue to rise.” There is great hope. Dr. Gorman understands the significant emotional and physical impact a breast cancer diagnosis can play in one’s life. Her team at Texas Breast Center is dedicated to offering patients personalized, advanced care in the treatment of breast cancer recurrence and the prevention of recurrence, as well as support that lasts long after your treatment regimen.

Our previous article: https://www.texasbreastcenter.com/breast-cancer/breast-cancer-recurrence-what-and-why

New Data: https://www.medscape.com/viewarticle/963031?uac=390358FV&faf=1&sso=true&impID=3870849&src=mkm_ret_211213_mscpmrk_BC_Monthly

 


Breast Cancer Recurrence: What and Why?

When breast cancer comes backs, it is called recurrence. While those who have a recurrence are not in the majority, they are certainly not a rarity or an impossibility. Recurrences typically happen within the first five years after treatment but can occur at any time and have a few ways of returning. To help ease some of the worries of these first few cancer-free years, we want to give some clarity and explanation into what breast cancer recurrence is and what to look for.

See updated data from 2022 on the recurrence of breast cancer.

Causes

Breast cancer recurrence occurs when cells from your original breast cancer manage to escape being treated and begin growing again. This process can sometimes take years. The cancer cells will lay dormant until something kick starts them into growing again.

Risks

Many of the recurrence risk factors are determined by the original tumor and cancer, though the patient determines some. These risk factors include:

  • A large tumor–A larger tumor increases the risk of cells being left behind.
  • Close or positive tumor margins–During surgery, when the surgeon removes the cancer, they will remove a small amount of healthy tissue around it. The tissue is then examined with a microscope. If it is clear of cancer, the margin is considered negative. However, if there are any cells left (considered a positive margin), risk or recurrence increases.
  • Lymph node infection–The risk of recurrence increases if cancer was found in lymph nodes at your original diagnosis.
  • No radiation treatment post-surgery–While most who undergo a lumpectomy choose to receive radiation therapy in the area of cancer afterward to reduce the risk of recurrence, some do not.
  • Inflammatory breast cancer–This type of breast cancer increases the risk of a local recurrence.
  • Specific cancer cell characteristics–Having triple-negative breast cancer or cancer resistant to hormone therapy can increase your risk.
  • No endocrine therapy–For certain types of breast cancer, not receiving endocrine therapy can raise the risk of recurrence in cancer patients.
  • Younger age–Those of a younger age during their initial breast cancer diagnosis, specifically under 35, have a higher risk of their cancer returning, despite generally older generally being a risk factor of cancer in general.
  • Obesity–Increased body mass index increases the risk of breast cancer coming back.

Prevention

There are methods and steps you can take to reduce your risk of recurrence of breast cancer, many in your initial treatment.

  • Chemotherapy–Those with an increased chance of recurrent breast cancer have been shown to have a decreased risk when treated with chemo.
  • Hormone therapy–If you have receptor-positive breast cancer, taking hormone therapy in your initial treatment can reduce your risk. This treatment method can sometimes continue for five or more years.
  • Targeted therapy–If your cancer produced additional HER2 proteins, targeted drug and treatment might reduce your risk.
  • Radiation therapy–A previous breast cancer patient with a large tumor, a breast-sparing operation, or inflammatory cancer would have reduced risk if treated with radiation treatment.
  • Bone-Building–Bone building medications can reduce the risk of recurrence taking place in bones, otherwise known as bone metastasis, for those with a high risk.
  • Healthy Diet–To decrease your risk of breast cancer recurrence, be sure to include plenty of fruits, vegetables, and whole grains in your diet, as well as limiting alcohol to one drink a day.
  • Exercising–Exercising regularly may help reduce your risk.

Kinds of Recurrence

Recurrent breast cancer can take one of three forms, defined by where it appears in reference to the primary cancer and treatment. The three types are local, regional, and distant recurrence.

Local

A local recurrence occurs when cancer cells grow in the same area as your previous cancer. If a lumpectomy was used for treatment (rather than a full mastectomy), cancer might start to regrow in the breast tissue that remains. If a complete mastectomy were performed, the tissue along the skin or chest wall would hold the recurring breast cancer.

Some signs that local recurrence is occurring are:

  • One or more painless lumps, nodules, or irregular areas of firmness under the skin
  • Newly thickened areas along mastectomy scars
  • Changes to the skin (inflammation, redness, changes in texture)
  • Nipple discharge

Many of the signs of a local recurrence are similar to those of initial breast cancer. After treatment, it does not hurt and may help to continue self-breast exams to keep an eye out for any changes, just in case.

Regional

Regional recurrence also happens rather close to the original site of infection. However, the difference between regional and local recurrence is a matter of lymph nodes. In regional recurrence, the local lymph nodes, such as those under the arm, will be infected with cancer.

Signs of regional recurrence cancer may include a lump or swelling in lymph nodes, so continue your self-checks in these areas:

  • Under the arm
  • Along the neck
  • Near and in the groove above the collarbone

This kind of recurrent breast cancer can almost be considered a subset of local recurrence and can many times be found by being familiar with your own body. Regular self-breast checks are just as necessary after breast cancer treatments as they are before.

Distant

Distant recurrence is when cancer recurred somewhere in the body away from the original site. This can include other organs such as the lungs or even bones. In this case, the patient is generally treated much in the same way as those diagnosed with stage IV breast cancer. However, treatment can vary from standard stage IV treatment based on the responses to previous treatments.

Treatment

Treatment, many times, is determined by the kind of breast cancer recurrence found. Local will be treated differently from regional will be treated differently from different.

Local Treatment

Local breast cancer recurrence is, if possible, treated with surgical treatment. If a lumpectomy and radiation were used previously, then a mastectomy would be the first choice treatment. If a mastectomy was performed prior, the tumor would be removed, and the patient will be treated with radiation therapy if not already received.

Either way, both of these plans are likely to be accompanied by chemotherapy, targeted therapy, hormone therapy, or some combination to ensure a full recovery.

Regional Treatment

Sometimes breast cancer will come back in the lymph nodes. This can be treated by removing the lymph nodes themselves, followed by radiation in the surrounding area, if not already received. Systemic (targeted, hormone, or chemotherapy) treatment after surgery may be discussed on a case-by-case basis to ensure that any remaining cancer cells are eliminated.

Distant Treatment

The primary treatment for distant recurrent breast cancer will be a form of system treatment (hormone, targeted, or chemotherapy) based on how your cancer has responded before. You and your doctor can create a treatment plan that serves you well, knowing what has worked with these breast cancer cells previously and what has not.

Dr. Gorman

Dr. Valerie Gorman and the Texas Breast Center are aware of the risks of recurrent breast cancer and the chances that your breast cancer may come back. This is why she and her team stay with you through your personalized treatment and long after to make sure you know that you always have a support system, whether you need it or not.

Dr. Gorman specializes in surgical oncology and surgical diseases of the breast. She serves as the Medical Director of Surgical Services at Baylor Scott & White Medical Center as well as the Chief of Surgery.