Dr. David Weintritt at Inova pioneers SPY Imaging for breast cancer surgery

SPYing on Breast Cancer

Inova is the first in the world to use a groundbreaking technique that reduces complications during breast reconstruction

To improve outcomes in breast cancer surgery, a surgeon at the Breast Cancer Program at Inova Mount Vernon Hospital has added a new tool in the fight. Known as the SPY Portable Handheld Imaging System (SPY-PHI), the state-of-the-art device uses infrared fluorescence imaging to allow real-time measurement of tissue perfusion to reduce complications during breast reconstruction. Fluorescence imaging has also been used successfully to identify when abnormal cancer cells migrate to nearby lymph nodes.

“SPY-PHI appears to be a much more accurate visual tool than what is currently used for lymph-node mapping procedures, because it shows pathways so much more vividly,” says David Weintritt, MD, FACS, Director of Inova Mount Vernon Breast Care Program and founder of the National Breast Center, and the first surgeon worldwide to use SPY-PHI in breast cancer treatment. “This technology increases the certainty that I will be able to find the correct lymph node when performing a minimally invasive sentinel lymph node biopsy.” In April, Inova Mount Vernon patient Judy Short became the first person in the world to benefit from this new procedure.

Precision Surveillance for Lymph Node Mapping

Lymph node mapping is useful in determining whether cancer has spread to other parts of the body. It also helps the surgeon determine the stage of breast cancer as well as the best course of treatment to prevent recurrence.

By performing lymph node mapping using fluorescent imaging and SPY-PHI, a surgeon can precisely track a cancer’s pathway through the lymphatic system to identify if the cancer has metastasized. Typically, when breast cancer spreads away from a tumor, the first place it reaches is a sentinel lymph node in the underarm area. Using fluorescent imaging technology, the surgeon injects a small amount of nontoxic indocyanine green (ICG) dye into or near the tumor in the breast, then traces its path using infrared light. “The intensity of the visual with the green dye is incomparable relative to the older technique using blue dye,” says Dr. Weintritt.

Once the sentinel node is identified, the surgeon removes it and sends it to a pathologist for evaluation. If abnormal cells are not present in the sentinel node, then it is unlikely that other nodes are cancerous, reducing the need for further lymph node removal.

SPY-PHI imaging can be performed right at the time of surgery. “There’s no additional difficulty from a scheduling standpoint, there’s no pain for the patient, and it allows us to complete the overall process of surgery faster and more safely,” Dr. Weintritt says.

Breast Cancer Clinical Trial: SPY-PHI Study

The Inova Mount Vernon Breast Care Program is working to develop a nationwide clinical trial to study SPY-PHI lymph node mapping for breast cancer. To learn more about the Film B trial, call 571-472-4724.