Breast Service

Breast Cancer Research

Surgical Clinical Trials

The American College of Surgeon Oncology Group is sponsoring two studies of breast lymphatic mapping. Z0010 Sentinel Node Surgery in Early Stage Breast Cancer and Z0011 A randomized, prospective study of sentinel node surgery versus conventional axillary dissection in patients with a positive axillary node.
Dr Kyo Chu, PI

These two studies will determine if patients benefit from the more limited "sentinel node" surgery that we are performing to minimize recovery time and the complications that may sometimes occur with the axillary (underarm) node surgery that is a part of the staging of breast cancer. Furthermore, we will follow patients for five years to see if they have any improvement in survival with the more intensive screening of their axillary nodes.

For more information about either of these trials, we may be contacted through 804-243-4811 or kuc4u@virginia.edu

Digital and MR Research

One of the greatest difficulties in reading mammograms is evaluating women with dense breast tissue since cancers, which appear as white masses, blend in with breast tissue, which is also white. Researchers in the division of Breast Imaging at the University of Virginia are developing ways of finding these cancers earlier and trying to understand why some breasts have this appearance. Mark Williams, Ph.D., and Samuel Dwyer, Ph.D., have been leaders in the field of digital mammography, which uses computers to form an image of the breast. Computers can be used to enhance the images in order to visualize the breast tissue better. Since mammography does not optimally evaluate every woman, research at UVA is also investigating other ways of looking at the breast. Dr. Gia DeAngelis currently heads the UVA site of two multi-center trials using magnetic resonance imaging (MRI). One trial uses MRI to characterize breast abnormalities, while the second uses MRI to screen women at high risk for developing breast cancer. Scintimammography is another technique to look at the breast and uses radioactive material injected through a vein. While this test is currently commercially available, the resolution is poor. However, Dr. Williams is developing high-resolution detectors for this technique. Answers are also needed as to what causes the breast tissue to become dense. Dr. Jennifer Harvey, working with Dr. Richard Santen of Endocrinology at UVA, is investigating the biochemical and tissue changes that occur when women take estrogen and how they affect the appearance of the mammogram. By exploring both means to improve imaging and the biochemical basis for the appearance of the breast, researchers at UVA intend to improve breast cancer detection.

Fibrin Sealant Studies

Fibrin sealant studies have involved three stages of work: Bench research, See reference 1 followed by UVA in-house pilot study involving 30 randomized patients See reference 2, and industry supported (American Red Cross and VItex Pharmaceuticals) Phase I, II and III trials led by UVA. 59 UVA patients were enrolled along with 270 total patients at seven institutions (UVA serving as the lead institution) for the seven center multi-site trial. Other institutions include: Memorial Sloan-Kettering, Northwestern, Ohio State, U Florida, and Providence.

The work has resulted in a commercially available product currently used in our operating room for cancer procedures including breast cancer, but also melanoma, thoracic cancer, and gynecologic malignancies. Non-cancer applications include orthopedic, plastic surgery and vascular surgery procedures. Fibrin sealant is a good example of the translation of research from benchwork to a widely useful commercial application. We presented our experience using fibrin for a novel application--to treat recurrent breast seromas after irradiation-- in a poster at the Society of Surgical Oncology in March 1999.

1. Sanders, RP, Goodman, NC, Amiss LR, Pierce, RA, Moore MM, Marx, G, Morgan, RF, Spotnitz, WD. Effect of Fibrinogen and Thrombin Concentrations on Mastectomy Seroma Prevention. Journal of Surgical Research 61(1) 65-70, 1996 Feb 15,
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2. Moore MM, Nguyen DH, Spotnitz WD. Fibrin Sealant Reduces Serous Drainage and Allows for Earlier Drain Removal After Axillary Dissection: A Randomized, Prospective Trial. American Surgeon 63(1) 97-102, 1997 Jan,
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