From Women’s History Month in March through Women’s Health Month in 
May, what better time to focus on advancements made in breast cancer treatment, and what better representative than Dr. Chelsea R. Fisher, a surgeon recently hired at St. Joseph Medical Center in Kansas City who dedicates her professional life to improving women’s chances for surviving breast cancer and is also a wife and mother of three.
Among other specialties, Dr. Fisher is a doctor of osteopathy and a medical director who specializes in breast surgery, mastectomy surgery and breast conservation therapy. She is optimistic that as more cancers are found at their earliest, most treatable stages, women’s chances for survival are improving, along with more treatment options. She is especially encouraged by a radiation treatment known as the SAVI Catheter Placements for Breast Radiation.
FDA-approved in 2006, the SAVI medical device has fewer side effects and proven longer term positive outcomes for women with early stage breast cancer.
“This treatment option provides targeted and customized radiation where it’s needed most while protecting healthy breast and surrounding tissue,” says Dr. Fisher. “And with decreased toxicity, much fewer side effects, and a drastic reduction in treatment time, it’s truly a bright side to an otherwise distressing time for many women.”
The SAVI is a strut-based applicator that delivers a form of accelerated partial breast irradiation (APBI) known as a breast brachytherapy (or internal radiation therapy), a short-course of targeted radiation for early-stage breast cancer that can be completed in as little as 2-5 days.
The specialized device uses a bundle of catheters that resembles an umbrella to deliver radiation internally following a lumpectomy. Rather than exposing the breast to external beam radiation, which can damage underlying tissues of the breast or lung, the SAVI system delivers radiation from within using an implantable device that conforms to the shape of the surgical cavity breast.
With little pain, it is inserted into the tumor cavity through a small incision in the breast. The catheters are expanded to fit the size and shape of the cavity, and a tiny radioactive seed is placed in each catheter to deliver an individual dose of radiation. (Radiation does not remain in the body between treatment sessions.) SAVI remains in the breast during the entire course of treatment, so patients must refrain from showering. However, the device is carefully secured with gauze to minimize movement between treatments, and many women report minimal disruption to their daily lives. While some women choose to take time off from work and other activities, others are able to carry on their normal schedules during the 2–5 days of treatment and resume their normal daily activities immediately following treatment.
“SAVI was developed so more women with early-stage breast cancer could choose breast conservation therapy without a major interruption in their work and family life,” says Dr. Fisher. “It also increases the number of women who are eligible for treatment, regardless of breast shape or size, with better cosmetic results and nearly the same efficacy as whole-breast irradiation. I’d call it truly next level and revolutionary.”
Fisher adds that 20 years ago, the standard treatment for women diagnosed with breast cancer was a mastectomy (removal of the entire breast). Today, physicians agree that Breast Conservation Therapy (BCT) is as effective as mastectomy in decreasing the risk of local recurrence, and with the pinpoint accuracy of the SAVI device, physicians can precisely deliver treatment to the tumor cavity and spare the surrounding tissue.
Dr. Fisher urges the Kansas City community to use the next two months dedicated to women and women’s heath to focus on making their long overdue appointments.
“Please do not let the ongoing pandemic prevent you or the women you love from getting the necessary scans to detect breast cancers early on,” Fisher states. “And if you have delayed treatment, realize that with the SAVI, you could be completely done with your treatment in as little as two days with minimal contact interactions along with the profound hope of seeing many more tomorrows.”
Dr. Fisher graduated from the University of Kansas, where she earned a bachelor’s degree and master’s degree in public health. Dr. Fisher graduated from the Kansas City University of Medicine and Biosciences in 2010 and completed her general surgery residency at Truman Medical Center and St. Luke’s on the Plaza through the University of Missouri Kansas City (UMKC). Dr. Fisher’s clinical interests include breast surgery, complex hernia repairs, as well as robotic and minimally invasive colon surgeries.
To schedule an appt. with Dr. Fisher, please call: 816-254-9292. To schedule a mammogram, call 816-943-4799.
How SAVI Procedure Saves Women’s Lives at St. Joseph Medical Center
SAVI Brachy uses thin tubes (catheters) to deliver radiation directly to the lumpectomy site. The catheters gently expand to fit the size and shape of the tumor cavity. A tiny radiation seed travels through each catheter to deliver a precise dose of radiation, customized for the exact size, shape or location of the target tissue.
PLACEMENT
The SAVI Brachy applicator is gently inserted in a closed position into the tumor cavity through a small incision.
EXPANSION
The catheters are gently expanded to conform to the shape of the cavity. This is done only once, at the beginning of treatment.
RADIATION DELIVERY
Once the catheter is in place, a radiation oncologist delivers treatment twice a day for 2-5 days. The ends of the catheters are connected to a computerized delivery system that painlessly delivers a tiny radioactive seed into each tube. The radiation source is completely removed after each treatment – no radiation remains in the body between treatments.
REMOVAL
After the last radiation treatment, the physician will close the device and remove it through the same incision into which it was originally inserted.