"Truly Life-Changing" - Patient Holly Miller and Shawna Willey, MD on the unrivalled benefits of Magtrace®
The ‘delayed’ sentinel lymph node biopsy has shown that 80% of women with high-risk DCIS can avoid unnecessary axilla surgery - but what is it like for patients who have to return?
Holly Miller, mother to a 12-year-old daughter in Virginia, was diagnosed with early-stage breast cancer back in April 2021, following a routine mammogram. Imaging and biopsy both identified suspicious DCIS in her right breast.
As is the case for most women in Holly’s situation, there was initial trepidation, followed by a desire to learn about her options to enable her to tackle the diagnosis in the best possible way.
In speaking to her surgeon, Shawna Willey, MD, she discovered the ‘delayed’ sentinel lymph node biopsy, a procedure currently indicated for use in patients undergoing mastectomy in the US only.
“Dr Willey was great in telling me about some of the latest procedures, including a new procedure [delayed SLNB] with Magtrace” explained Holly.
Holly underwent a mastectomy on her right breast and full reconstruction, with the Magtrace® lymphatic tracer injected in the OR ahead of surgery.
Unfortunately, the results from pathology showed that she was in the roughly 20% minority of patients with invasive DCIS, and further surgery would be required. “It was a surprise to get the phone call to say that I had invasive cancer.” Holly explained.
Fortunately, her breast surgeon was Dr Willey of the Inova Schar Cancer Institute in Fairfax, who had developed a passion for patient-centred care, offering techniques such as nipple-sparing and risk-reducing mastectomies. However, Dr Willey admitted that there had long been difficulties in assessing whether sentinel lymph nodes needed to be removed or not.
That conundrum led to the adoption of Magtrace® to lead the way in offering a pioneering new standard of care for women with a DCIS diagnosis, that reduced the associated risk of lymphedema for patients undergoing treatment.
Why Magtrace® is such a breakthrough technology
“By using Magtrace and injecting it at the time of their mastectomy, we can actually wait until we get the final pathology back,” explained Dr Willey.
“Our pathologists can tell us whether or not there is an invasive cancer, and if there is we can go back and take that lymph node out because we know exactly where it is by injecting the Magtrace at the time of mastectomy.”
Holly was just one of three patients from Dr Willey's first 40 to have to return to the operating room, but it was explained that the procedure was straightforward. Best of all, the removed lymph nodes were clear of cancer, meaning the cancer had not spread to the underarm.
“I was relieved beyond words to know that the cancer had not spread. It was a big relief to me - truly life-changing”Holly Miller
SLNB becoming a rare occurrence
The positive news for most women visiting Dr Willey and undergoing a mastectomy with the ‘delayed’ sentinel lymph node biopsy technique, is that the need for further axillary surgery is becoming obsolete for the majority.
“In our first 40 patients, we found that 37 patients avoided having their lymph nodes removed, and avoided that 4-7% chance of having lymphedema”Dr Shawna Willey - Inova Schar Cancer Institute
So, could this procedure become the new standardized procedure for physicians treating patients with high-risk DCIS?
“I do believe that given enough time and disbursement of information and the technology, that delayed SLNB will become the standard of care, partially because it will be driven by patients who know about lymphedema and really want to avoid it” said Dr Willey.
“And also, because it makes sense to surgeons to say, ‘why should we take out something we don’t absolutely know we have to remove’?”
A new lease of life for Holly
Avoiding the potential risk of lymphedema has left Holly with a fresh outlook on life and a desire to continue to spend more time with her family.
“I have an active life and I’m back swimming and playing tennis and pickleball with my daughter. I’m so relieved the cancer is gone and I was able to beat it” said Holly.
Looking back on the decision to opt for this procedure, she explained how delighted she was with the results and how patient-friendly the whole process was.
“It’s such an easy procedure from the patient side of view – it doesn’t hurt, it leaves no marks but most of all it gives you concrete results.”
"I hope that other patients ask about it – say the word Magtrace and see what your doctor has to say - because it really is such a simple solution and has been life-changing for me”Holly Miller