East Texas Hospitals Discuss New Technologies and Breast Cancer Programs | Local News



Over the years, technology continues to advance, allowing more services to become available to better identify and fight breast cancer.

From small microchips that more easily identify the location of cancer in the breast, to survivorship programs to keep patients informed and connected to resources, breast cancer advances have come a long way.


“I think we have the cutting edge technology at (UT Health East Texas),” said breast cancer surgeon Dr. Christine Moulds-Merritt.

Some of the biggest technological developments have been the radio frequency identification tag and the 3D mammography, or tomosynthesis, machine.

The RFID tag is a technology that places a chip in the cancerous area of ​​a breast, showing surgeons exactly where it is, said Dr. Michael Klouda, diagnostic radiologist at UT Health East Texas Breast Care Center.

“It’s like a GPS for cancer,” Moulds-Merritt said.

The chip is introduced into the breast with a hollow needle type tool. The tool can make a small incision and deploy the chip in the breast.

Klouda said that by inserting the chip, the breast would be numb before the incision was made. To make sure the chip is in the right place, things like ultrasound can be used simultaneously so doctors can monitor what they’re doing in the breast.

Each chip has a unique identification number for the patient, he said. Doctors can scan the chip to locate it and retrieve that individual number.

Before RFID tags, Moulds-Merritt said patients had to come in the morning before their surgery for another mammogram, have the area numbed, and then a wire would be inserted into the breast around the cancerous tissue. Due to this thread protruding partly from the breast, patients could not leave the hospital once the thread was inserted.

With an RFID tag, patients can schedule surgery at their convenience and, if necessary, even travel to another hospital for the procedure, she said.

Another benefit is that for surgery, the patient walks into the operating room and a probe can be used to find exactly where the chip was implanted, Moulds-Merritt said. So during the surgery she can choose a better place for an incision to remove the cancer.

With the wire method of locating cancer, doctors must follow the wire to the cancerous mass, which puts the doctor in a more difficult position when it comes to determining where to make incisions, sometimes resulting in removing more tissue than necessary, said Dr. Brandon Ashton, diagnostic radiologist at UT Health East Texas Breast Care Center.

“This RFID, you put it in the mast, and then the surgeon can choose maybe the best anatomical place – the closest place – to make the incision and hide the scar, make the scar smaller,” said Ashton. “And so there is an advantage there as well for the surgical approach.

Since it’s a chip, you can also confirm it was removed during surgery, Ashton said. Doctors also make sure it is removed using a device to make sure the chip is in the removed tissue and an x-ray.

Besides the RFID tag, 3D mammography has changed and improved the way doctors find cancerous masses.

UT Health East Texas Breast Care Center diagnostic radiologist Dr. Brandon Ashton demonstrates how a 3D mammography machine works.

Before 3D mammography, 2D mammography was used, Ashton said. With 2D, the breast was flattened, everything overlapped, and images could only be taken from a few different views. 3D mammography takes pictures in an arc, dividing the breast into small slices and giving doctors a non-overlapping view.

“We do what are called callbacks if we see anything abnormal on a screening mammogram,” Ashton said. “We have fewer reminders for things that aren’t important with 3D mammography or tomosynthesis, and more reminders that identify cancer. So you find the good stuff with technology.

UT Health East Texas also has a mobile mammography bus with 3D mammography machines. This bus can visit rural areas and offer patients the “best” treatment.

The hospital got its first 3D mammography machine about four years ago and has since changed all screening machines to 3D, Ashton said.

Although 3D mammography machines are most commonly used to examine breasts for cancer, MRIs and ultrasounds can also be used.

“Ultrasound is a real boom because you’re not exposed to radiation,” Klouda said.

Ultrasound uses sound waves to capture images, Ashton said. On the 3D mammography machine, the cancer and the dense tissue of the breast are white whereas with the ultrasound the cancerous areas will be dark.

MRIs use magnets to create images from different tissue features, Ashton said. There is no radiation involved, but patients will be injected with contrast material. It allows “a level of information that mammograms don’t have, and that’s blood flow,” he said.

When you can look at the blood flow, Ashton said, sometimes you can find cancers that haven’t made a structural change yet, but you can see the difference in blood flow where the cancer might be growing.

An MRI is even better at detecting cancer than 3D mammography, but it is not used on a yearly basis for patients unless they have a diagnosis of cancer or a family history of cancer, he said. -he declares.

Going forward, Aston said it would like to see “MRIs become cheap enough and available enough to be used as a screening method. It’s too expensive and there isn’t enough equipment available to screen all women, so it could be improved.


At Christus Health, a new survivorship program for breast cancer survivors has recently begun.

The survivorship program is for those who have had the last treatment for breast cancer, whether surgery, chemotherapy or radiation therapy, said clinician Dr Jacob Krause in advanced survival practice.

Ideally, Krause said he likes patients to visit a few weeks after final treatment, but he’ll see them for up to six months.

Krause’s first visit with patients is “global,” he said. Although he still does things like physical exams, he also sits down and talks about how everything is going after the treatment, explaining all about their cancer in depth, why they got the treatment they did , if they suffer from depression or anxiety and other things.

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Dr. Jacob Krause, an advanced practice survivorship clinician, stands in a room where he would talk to patients about the survivorship program.

The most important thing with the survivorship program is to go back and explain a patient’s cancer pathology so they understand everything, Krause said. Some doctor visits during the treatment process will be short and things can get “swept away”, so it’s important to help people understand, he added.

During the visit, Krause said there were times when he talked very little about cancer with a patient and more about how life was going and vice versa. It’s really fair regardless of the patient


“Some people need a little more to get their life back together and do it all,” he said. “And of course every patient is different, so it all depends on the scenario.”

“I think for a lot of them, just having another resource, another person to talk to, is helpful.”

After the first visit, he said he would then see the patients once a year to make sure they were still having mammograms and that everything was going well.

The survivorship program has been actively seeing patients since about April, Krause said. During this period, he said he visited about 90 people. In a year, about 400 people will pass through the hospital with breast cancer.

Sometimes it’s hard to explain to people what exactly the survival program is, but those who go through it “seem really happy and happy that they did it every time they come and have finally been through everything,” he said. he declared.

In talking with people, Krause said he was able to refer them to other resources as needed, such as physiotherapy and counseling services.

As long as people are able to provide access to their records so they know about their cancer and their treatment, they can be part of the survivorship program, Krause said. With this information, he is able to create a survivor note with details about their cancer.

“I’m happy to talk to anyone if they have any problems. I might not be able to write a very good survival note form if I don’t have all the information, but I would always be willing to talk to anyone,” he said.

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