Easing post-op patients’ suffering
Dr Jason Copeland leads Jamaican team of pioneers in breast cancer-linked surgery
Published:Tuesday | February 6, 2024 | 4:42 AMSashana Small/Staff Reporter
Two years after the 2020 establishment of the Breast Health and Oncology Centre at Andrews Memorial Hospital, founding clinical director and oncologist Dr Jason Copeland and his team became pioneers of a new method for performing a breast cancer-related surgery that he says will reduce the postoperative suffering of patients.
The new surgical method was developed for targeted axillary lymph node localisation and removal.
“It (morbidity) is a big problem, not just in our country, but in developing countries where the surgeries that we tend to offer are a little bit more morbid, has more complications and, whenever we are able to de-escalate the extensiveness of our surgeries with the same oncological outcome, that is important and that is what we’re trying to do,” Copeland told The Gleaner last week, ahead of yesterday’s recognition of World Cancer Day.
Lymph nodes are small organs that filter substances in the body, and are made up of cells that help fight infections. When breast cancer spreads, it typically goes to nearby lymph nodes under the arms.
In 2022, Jamaica recorded 1,327 new cases of breast cancer, and 684 breast cancer-related deaths.
Copeland explained that the procedure was first performed in May 2022, and the technique can replace axillary lymph node dissection in selected patients, thereby decreasing lymphedema rates, the rates of nerve damage and chronic postoperative pain syndromes.
The surgery, first performed on a 59-year-old postmenopausal female who had a one-month history of a painless left breast lump, was described in detail and published in the Journal of Medical Cases in December 2023.
TECHNIQUE
“The technique uses a short acting radioactive material called Technetium 99m, which is used commonly in medical imaging locally. This material is injected directly into previously identified abnormal axillary lymph nodes of selected breast cancer patients after they have completed chemotherapy at the time of their definitive breast surgery. A device that picks up the emitted gamma radiation is then used to precisely identify these abnormal node/nodes and they are removed,” Copeland explained.
Not only is this method less risky, but Copeland disclosed that it is a less-expensive technique than the ones used in more developed countries.
“We’re very proud of it because it’s something that we conceptualised, because, for axillary lymph node localisation surgeries, usually the set up for it can be quite expensive in terms of getting the actual seeds that we place in the lymph node as well as the localisation machinery and so we have not been practising axillary lymph node … targeted localisation here in Jamaica,” he said.
Another advantage of this technique he noted, is its teachability.
No other surgeries have been performed using this technique since the first one two years ago, but Copeland said he has some patients in line who fit the criteria for surgery that will be done this year.
And, since the publication of the article in December last year, he said he has been receiving interest in the procedure from all over the world.
Copeland said approximately 50 breast cancer-related surgeries are performed at the centre each year which includes mastectomies, breast reconstruction, and axillary lymph node surgeries.
With this in mind, he said he and his team will always be exploring ways in which they can innovate.
“With breast surgery, it advances very rapidly and most of the advances tend to be in radiation, chemotherapy. But, over the past three decades or so, there has been quite a significant change in terms of how we perform breast surgery itself,” he said. “There are always opportunities to refine what we have been doing, and there’s an evolution in that form of surgery.”