Dr. Tejpar, Orlando breast surgeon & breast cancer surgery

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Dr. Nafisa A. Tejpar
Orlando , FL 32804

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Nafisa Tejpar, MD, FACS
Specialist in Breast Cancer Surgery & Evaluation

Committed to excellence in your healthcare

Radioactive Seed Localization of Small Breast Tumors

   A recent article in The Orlando Sentinel gave both a patient and physician perspective on using this procedure for precise location of small breast tumors. Dr. Tejpar has received the training and has significant experience in using this procedure for certain patients.

What is it?
You may have read on our site about ultrasound and mammography guided biopsies when an abnormality in the breast is too small to be felt by the surgeon. Sometimes, a surgeon uses wire localization to help her pinpoint where she needs to remove a small breast cancer tumor. When needed, the traditional approach was to numb the breast and then insert a thin needle into the breast before the surgery. A very thin wire is guided through the hollow needle by x-ray to the suspicious area in the breast. The surgeon can then follow that wire to remove the breast cancer and surrounding tissue during the surgery.

Radioactive seed localization is a newer approach that uses 1-2 tiny seeds inserted through a hollow needle instead of the wire. It has several advantages over wire localization. It minimizes discomfort to the patient. It is less likely to move than a wire that sticks out of the breast. Most importantly, clinical trials show that use of the seeds significantly improve a surgeon's ability to obtain 'clean margins' and avoid a second surgery. While Dr. Tejpar has always focused on obtaining clean margins, this new procedure can be used with some patients to improve the success even more.

What are 'clean margins'? When a surgeon removes a tumor or suspicious area, the pathologist looks at the edges of the tissue removed, not just the tumor itself. They check to make sure all the surrounding edges are free of cancer cells. This helps determine whether additional surgery is needed to remove more tissue and what will be needed for further treatment.

Negative or 'Clean' Margins
Positive or 'Dirty' Margins

The radioactive seed localization uses sealed radioactive capsules .17 of an inch by .03 of an inch guided by mammography. This is the actual size:

radioactive seed localization for breast cancer

One or two seeds are inserted to pinpoint the breast cancer tumor area. A seed contains 0.125- 0.025 millicuries of iodine 125. (less than a mammogram) A gamma probe held by the surgeon shows greatest activity directly over the implanted seed and tumor/lesion. The surgeon is guided to the depth and both the tumor area and the seed are removed. The precision of it helps obtain the negative margins (clean margins). Patients rated the pain of insertion at a 2 on a scale of 1-10 with 10 being the highest. They rated convenience, especially when done the day before as a 10. And the seeds can be implanted up to 5 days in advance.

Before using this procedure, Dr. Tejpar researched the amount of radiation for the patient and found it to be miniscule for the patient. Since she is handling the tumors with the seeds, she is confident that it is safe both for patient and for her as the surgeon doing many of these procedures.





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