Latest / Becker’s Healthcare Podcast / Robotic Breast Surgery Advances and Personalized Cancer Care with Dr. Noran Barry

Transcript

Robotic Breast Surgery Advances and Personalized Cancer Care with Dr. Noran Barry · Becker’s Healthcare Podcast

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  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
• 0:08
  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where they go to
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  - pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
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  - Welcome to the Becker's Healthcare podcast. I'm your
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  - host, Kelly Gooch, managing editor at Becker's. Today,
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  - we're joined by doctor Noram Berry, medical director
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  - of breast health at Sharp Health Care and
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  - a surgeon affiliated with Sharp Mary Birch Hospital
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  - for Women in Newmoor.
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  - Doctor Berry, thank you so much for joining
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  - us. I'm excited about the conversation. And to
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  - start off, could you introduce yourself and tell
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  - us a little bit about your background?
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  - Yeah. Thanks, Kelly. Thanks so much for having
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  - me. So I'm a breast surgical oncologist.
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  - I'm based in San Diego.
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  - I, predominantly
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  - work at Sharp Mary Birch Hospital for Women's
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  - and and Infants.
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  - I've been with Sharp Re Steely Medical Group
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  - since 2022.
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  - I did my general surgery residency at St.
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  - Luke's University Hospital in Pennsylvania, and then I
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  - went on to do a breast surgical oncology
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  - fellowship at the University of Pittsburgh.
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  - And, I'm just really happy to be here.
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  - What drew me to breast surgery is just
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  - the relationship I get to have with women.
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  - And so I'm excited to kinda talk a
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  - little bit more about that.
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  - Yes. And a a perfect time, of course,
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  - being breast cancer awareness month to to talk
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  - about this topic. So thank you for joining
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  - us again. We appreciate it.
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  - My pleasure.
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  - Of course. I I wanted to start off
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  - and
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  - ask you
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  - about a new surgical option that I know
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  - you're able to offer at Mary... At Sharp
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  - Mary Birch. Could you
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  - explain a little bit about that option?
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  - Yeah. So, right now, we're now offering a
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  - robotic
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  - single port nipple sparing mastectomy
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  - using,
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  - the DaVinci
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  - robotic system.
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  - It really allows me to remove the breast
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  - through one small incision,
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  - which is placed on the side of the
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  - chest kind of near the armpit.
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  - And that preserves the skin
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  - and the nipple for reconstruction.
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  - It also, you know,
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  - in contrast
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  - to traditional mastectomy
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  - where there's
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  - a fairly large incision on the breast,
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  - this hides the incision. And,
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  - the goal is to make it look as
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  - natural
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  - as possible so that women can feel more
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  - like themselves again and that cancer can take
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  - less from them. And so this is an
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  - incredible thing that,
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  - I'm able to offer here. I'm one of
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  - 15 surgeons across the country.
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  - The surgery was actually cleared by the FDA
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  - in December
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  - 2025,
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  - so it's it's genuinely new.
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  - And, and it's exciting time to be able
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  - to bring that to San Diego so women
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  - don't have to travel as far to have
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  - access to excellent care.
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  - Well, that's truly amazing and and really novel,
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  - it sounds like, from all all aspects. And
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  - so can you explain a little more maybe
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  - about how this procedure is different from previous
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  - techniques and what maybe makes it a better
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  - option for some patients?
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  - Yeah. So a traditional nipple sparing mastectomy
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  - kind of involves this longer about
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  - 10 centimeter
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  - incision, 10 to 15 centimeter incision
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  - along the crease of where your breast kind
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  - of meets your abdomen, what we call the
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  - inframammary fold.
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  - And that's where that, you know, this large
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  - incision happens. That's where the breast gland is
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  - removed ultimately,
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  - and a skin pocket is left behind, which
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  - is, you know, the skin, the nipple, etcetera.
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  - And the goal is always to make it
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  - look as natural as possible by preserving the
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  - nipple, preserving the skin.
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  - The problem is that there can be complications
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  - associated with that. So,
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  - decrease in the blood supply to the skin
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  - and to the nipple,
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  - as well as just having the patient
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  - looking in the mirror
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  - and
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  - being reminded of her breast cancer treatment,
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  - you know, day in and day out. There's
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  - a whole psychosocial aspect to this.
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  - With this new technique,
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  - we wanna remove that psychosocial aspect as best
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  - we... As we can. We're never gonna be
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  - able to remove it completely, but we wanna
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  - help alleviate it.
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  - So it's a smaller incision hidden under the
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  - armpit. So when a patient looks in the
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  - mirror, they feel a lot more like themselves.
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  - Yeah. Absolutely.
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  - And I know you mentioned earlier that,
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  - of course, really working with
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  - plastic surgeons in the reconstruction aspect. So can
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  - you explain a little more of how this
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  - approach really aids the plastic surgeon to partner
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  - with for breast reconstruction surgery?
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  - So, yeah, thanks for asking. Breast reconstruction
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  - and breast surgical oncology is truly a partnership.
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  - I work closely with my colleague, doctor Alfonso
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  - Camberos,
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  - And we think of it kind of as
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  - a relay.
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  - I do the cancer operation,
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  - then I... You know, he comes in, and
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  - he helps me rebuild and reconstruct
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  - the breast and... In the same surgery.
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  - Many patients will go direct to implant after
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  - that surgery
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  - as opposed to potentially getting something called a
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  - tissue expander,
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  - which is a a placeholder that is temporary.
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  - And I tell my patients it's lumpy bumpy,
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  - but it's temporary.
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  - And then what he needs from me is
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  - a healthy,
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  - well perfused skin envelope and nipple with good
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  - blood flow, and that's kind of his canvas.
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  - When
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  - I preserve that skin envelope and move the
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  - incision off the breast, he has more to
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  - work with, And the final result just looks
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  - a lot more natural,
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  - with no scar kind of across the reconstructed
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  - breast.
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  - So we plan these cases together. We're in
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  - constant communication.
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  - We take pictures and we share and we
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  - talk about how we're going to approach every
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  - patient. We look at the patient's anatomy and
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  - and and kind of identify her goals, of
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  - course. Right?
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  - Whether an implant
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  - going in right away is the best approach,
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  - etcetera.
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  - So
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  - patients really feel that coordination,
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  - and they know these two, you know,
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  - we are... These two surgeons thinking about their
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  - emotions really as one team.
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  - Absolutely. And, yeah, it sounds like a lot
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  - of collaboration there and working together,
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  - of course, for the patient. And and so
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  - speaking of the patient too,
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  - for those
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  - who do have breast cancer,
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  - how can they find out if they're eligible
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  - to have this procedure and and also any
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  - benefits specifically you wanna call out as far
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  - as what... How these robotic assisted surgeries,
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  - the benefits they have for patients who do
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  - do this?
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  - Yeah. Absolutely.
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  - Great question. I think the first step is
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  - to just simply ask,
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  - you know, when
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  - you talk to your breast surgeon, ask if
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  - there's a referral, you know, that can be
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  - placed to discuss if they're candidates for robotic
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  - surgery.
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  - One interesting thing that I wanted to mention
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  - also is that there's some early data now
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  - with the robotic approach
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  - that women can actually preserve
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  - or have very close
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  - to normal
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  - sensation preservation
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  - of their skin.
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  - And that is
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  - in contrast to the traditional approach where many
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  - times patients have
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  - little... Very little to no sensation to the
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  - skin and to the nipple.
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  - And what I'm talking about also is really
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  - protective sensation.
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  - So sensation to be able to feel like
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  - there's a heating pad on me, etcetera.
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  - So that is one of the incredible benefits.
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  - Not everyone is a candidate. So if,
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  - you know, patient's interested in discussing
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  - this... If this is... This procedure is right
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  - for them, then just talking to that breast
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  - surgeon.
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  - If...
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  - Then just discussing kind of where the tumor
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  - is located,
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  - the position of the nipple, the size of
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  - the breast, those are all factors that kind
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  - of shape whether or not this approach is
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  - the right and kind of best way of
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  - of treating the patient.
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  - Yeah. Absolutely. And I know
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  - our hospital and health system executive audience and,
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  - of course, we... Our audience being a lot
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  - of leaders as well as clinicians just across
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  - the industry We'll be interested to hear a
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  - little more too on
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  - when we talk about the use of this
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  - robotic technology, how Sharp is really
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  - really,
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  - unique
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  - in this area and and the operating room
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  - specifically,
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  - and also just
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  - how to talk to patients about robotics? I
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  - think our our executive and leadership audience would
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  - be interested in.
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  - Yeah. So what I will say, and I
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  - was lucky, is that Sharp has invested in
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  - robotic surgery across
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  - many specialties for years. So the culture and
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  - the infrastructure were already here.
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  - That foundation is kind of what made it
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  - possible to bring robotics into breast surgery quickly.
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  - The additional part of this is that, you
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  - know, women's health
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  - deserves dedicated focus.
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  - Women are the center of the household, and
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  - I'm lucky and privileged enough to work at
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  - a women's hospital.
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  - And there,
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  - you know, when an environment
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  - is coordinated and tailored
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  - specifically to women and built around women,
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  - then a hospital creates
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  - that space for innovation in women's care like
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  - this procedure.
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  - I think if, as a health care leader,
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  - if you already have a very robust robotics
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  - program, this will be an easy segue.
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  - It's the same operation
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  - just using a smaller incision
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  - with better visualization
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  - and more precise instrumentation.
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  - So it's a natural
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  - addition to any robotics program, and I felt
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  - that very much when I brought the surgery
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  - here.
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  - And I also wanted to ask you too
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  - just about about the area
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  - in general,
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  - being in San Diego and and also
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  - even beyond that,
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  - systems across the country, just
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  - anything you've learned about
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  - the importance of really having
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  - a dedicated hospital for women as you've you've
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  - been mentioning during our conversation today?
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  - Yeah. I mean, I think at Mary Birch,
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  - everyone from the nurses
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  - to the physicians,
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  - anesthesia,
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  - you know, all the ancillary staff. We are
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  - all centered.
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  - You know, we're all tailored
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  - to care for women
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  - and their needs across a lifetime. You know?
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  - So, really, from the birth of a baby
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  - to, you know, even a breast cancer diagnosis,
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  - a gynecologic,
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  - diagnosis.
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  - And so the focus shows up in that,
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  - you know, experience for women.
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  - I I love it there. I'm proud that,
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  - you know, we were the first center
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  - in Southern California to offer the robotic nipple
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  - sparing mastectomy
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  - off a clinical trial.
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  - And,
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  - as of right now, still continue to be.
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  - So,
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  - you know, what stood out to me and
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  - made
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  - it made it incredible for me as well
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  - is that I wanted to offer this to
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  - women of San Diego
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  - so they don't have to travel anywhere else
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  - to have access to state of the art
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  - novel approach. And and this is a game
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  - changer. I mean, this approach was recently presented
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  - at the American Society of Breast Surgeons
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  - in Seattle
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  - in May, and,
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  - you know, everyone wants to start participating. And
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  - it is...
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  - The goal is to convert all open nipple
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  - sparing mastectomies
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  - in the traditional approach
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  - to the robotic one,
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  - in the same way that we've converted
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  - open prostatectomies
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  - to robotic prostatectomies.
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  - We are heading into a time where
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  - robotics is going to take over specifically the
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  - surgical approach.
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  - Right. And and access to just... I know
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  - is,
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  - just so important for
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  - all hospitals and and hospital executives across the
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  - board. So thank you so much for outlining
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  - that aspect, and it just sounds like it's
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  - been a really
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  - amazing journey
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  - for you to care for women at the
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  - hospital and at Sharp Mary Birch. Is there
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  - anything else
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  - that we haven't covered during our conversation today
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  - that you'd want other leaders or your peers
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  - to know?
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  - I think that in summary, you know,
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  - we we... You know, if a patient
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  - is questioning whether or not, you know, they
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  - want a nipple sparing mastectomy and... Just for
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  - them to understand what options there are and
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  - to ask if they're candidates for this. They
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  - don't have to leave San Diego to get
• 13:21
  - world class cutting edge treatment. Right?
• 13:24
  - And I'm
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  - I'm just, really privileged to be able to
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  - be here today and share all this with
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  - you and,
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  - just remind folks, health care leaders or not,
• 13:34
  - to to get screening mammograms.
• 13:37
  - And,
• 13:38
  - yeah. So thank you so much for allowing
• 13:40
  - me to share this with you.
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  - Of course. It's, like I said, such a
• 13:45
  - timely conversation. So thank you so much for
• 13:47
  - joining us, doctor Berrien. We appreciate
• 13:49
  - the great conversation today. Thank you. Thank you.