A Clearer View to Success

All across Kaweah Health’s many people who work both on the front lines and behind the scenes to help save lives. Of course, there are the doctors, nurses, technologists, and other people you see, but there are also scientists, technicians, social workers, recruiters, planners, and more who have the same goal of caring for the community. These groups work together every day, sometimes in surprising ways.

In the early fall of 2023, Kaweah Health’s Chief Strategy Officer Marc Mertz and Director of Physician Recruitment/Relations J.C. Palermo were meeting with Visalia breast surgeon, Kyle Potts, MD, when they asked him if there was anything he needed to help him provide better outcomes to patients. Dr. Potts immediately thought of a new machine he had recently seen at a conference — a CT (3D) breast specimen imaging machine by a company named Clarix. The machine allows doctors to load a surgically-removed tumor from a breast cancer patient and scan it while still in the operating room, providing a highly detailed, 3D image in just three minutes.

Coincidently, Dr. Potts and fellow breast surgeon Carol Machado, MD, had recently been talking about getting new technology that could give them better and faster imaging capability during surgery. And while Dr. Potts appreciated the support from the hospital’s administration, he didn’t have any expectations. “I thought it was great they were interested in helping, but honestly I thought we were just talking about things,” says Dr. Potts.

Following the meeting, Mertz went to work behind the scenes, “After learning about the Clarix machine, I thought how great it would be if we could get one,” he says. “So, I took the idea to Kaweah Health Foundation Director Liz Wynn. The foundation has been instrumental in getting new, cutting-edge equipment for Kaweah Health.” Mertz is absolutely correct. Since its founding in 1979, Kaweah Health Foundation has raised more than $74 million for life-saving equipment supporting neurosurgery, neonatal intensive care, cardiac surgery, breast health, acute care, cancer radiation treatment, and more. Wynn and the foundation board were very interested in learning more about this new tool to help women fighting breast cancer, and the timing was ideal. “When Marc (Mertz) brought the idea to us, we were getting ready for our Think Pink fundraising campaign for Breast Cancer Awareness month in October,” says Wynn. “So, I invited Suzie Potts, Dr. Potts’ wife, to come and present at our next board meeting.” During the presentation, Suzie showed the board members the benefits of the machine, highlighting the positive impacts it would have for patients: shorter surgical times, less time under anesthesia, fewer follow-up surgeries, and faster recovery times.

The presentation made a strong impression, inspiring the board to act immediately. “After learning about the machine, the board members and I were really excited — two of them representing Graham and Associates and the Sence Foundation immediately stepped up to provide matching funds to help purchase the machine,” recalls Wynn. The board took a leap of faith and approved the purchase of the equipment prior to all the funds being raised. “The board believed that every week delayed was a week a breast cancer patient missed out on this amazing technology,” says Wynn. “Dr. Potts and Dr. Machado might perform more than 20 lumpectomies combined every week.”

Thanks to the passion of the board and dedication of the foundation, Dr. Potts and Dr. Machado were using the new machine to help evaluate cancerous tumors taken from patients by late November. As hoped, it only took a few cases before the machine showed its worth. During one of Dr. Potts’ first few surgeries using the new technology, the clear image showed that more tissue needed to be removed from the patient, likely preventing a second surgery.

Dr. Potts is both grateful and impressed by the quick work of the foundation to bring this new technology to the hospital. “I can’t say enough about Kaweah and the foundation,” he says. “We are very fortunate to have them in the community. They are helping to bring the best technology available to our patients.” Right now, Kaweah Health is one of only three hospital systems in California with this technology, and the only one north of Southern California.

Dr. Potts is a Visalia native and has been a general surgeon in Visalia for almost 20 years. When he started his career, he did a variety of procedures, and over time he has become one of the most trusted breast surgeons in the Central Valley, with medical breast procedures representing about 95 percent of his work. In his career he has seen the field of breast surgery greatly evolve. “It’s become very specialized and the techniques have developed tremendously,” he says. “It has led to a much higher skill level in surgeons and much better outcomes for patients.” Dr. Potts does about 10-15 procedures each week including biopsies and lumpectomies, helping hundreds of women in their battles against cancer each year.

Dr. Potts’ patients truly appreciate his experience, expertise, compassion, and honesty. When Sally Rogers first met with Dr. Potts in 2018, she was seen because of an abnormal mammogram result. “I was able to meet with Dr. Potts throughout my journey, starting before my diagnosis,” she says. “I was so scared at first, I just told him to remove both breasts, I didn’t care.” Dr. Potts was quick to calm Sally down and clearly explain everything about her case, what they knew, what they might find out, and exactly what her care plan would be. Leading into her surgery, Sally was in a much different frame of mind.

“The only way to explain it is that I felt completely safe. He was so clear about everything and answered every question I had,” she recalls. “And all of his staff were so amazing. They really do care about you.” After her successful treatment, Sally is cancer free, but still comes to an annual check in with Dr. Potts. “Early-stage cancer treatment is highly effective, with success rates well in the 90 percent range,” says Dr. Potts. “That’s why it’s so important for women to do an annual checkup and mammogram.”

The biggest challenge in breast cancer surgery is referred to as margin status. When a cancerous tumor is surgically removed, about 8 milliliters of normal tissue surrounding the tumor is also removed, called a margin. On average, about 30 percent of breast cancer surgery patients have to come back for additional surgery because cancerous tissue was present at the margin but not visible via x-ray. “For a long time, Dr. Machado and I had been talking about getting some kind of new technology to help us reduce the rate of additional surgeries,” says Dr. Potts. “If we could reduce that rate by half, it would make a huge difference to so many patients.” Being able to clearly see the widths of the margin is the key to removing all of the cancerous tissue. With traditional 2D imaging, measuring the margins around the tumor is difficult because doctors can only view a single, flat image. The margins under and above the tumor are hidden or obscured, and surgeons must rely on their skill and experience to remove the right amount of tissue. A 3D image, however, is made of hundreds of individual scans taken from multiple angles and stitched together using soft-ware, creating a final image which can be rotated, easily viewed, and measured from all sides. This 3D image removes most doubt about the margin status. “It’s an absolute game changer,” says Dr. Potts. “The ability to completely see the tumor you are working on in 3D is such an advantage. We can precisely and clearly visualize the exact location and details of a tumor and confidently determine and confirm all traces of a breast cancer tumor have been removed.” Dr. Potts emphasizes the high quality of care avail-able here in Tulare County. “You don’t have to go to Stanford or Fresno. You don’t have to go out of the area to continue your treatment. Kaweah Health is keeping the technology up to date here so we can continue to provide some of the best breast care.”