Ex Vivo Model of Biopsy Clip Migration in Breast Cancer; Network Disruptions in Reproductive Healthcare Leading to Dobbs V. Jackson

Women’s healthcare technologies represent a sociotechnical issue, requiring the analysis of both the social and technological dimensions. Both abortions and breast cancer biopsy clips are life-saving technologies that are, however, limited in their ability to fully benefit women’s health. Some breast cancer biopsy clips tend to migrate away from their initial insertion site which results in poorer margins for tumor removal, and there is not a good method to measure this. Understanding this migration is necessary to design clips that resist movement while still retaining the benefits of existing clip designs. Similarly, abortion and other reproductive healthcare technologies have been limited since the Dobbs v. Jackson decision, which removed the constitutional right to abortion. Understanding how the interactions between legislators, educators, and healthcare workers contributed to this is necessary in order to restore this access and prevent it from being taken away in the future. These two projects are related as both breast cancer biopsy clips and reproductive healthcare technologies are necessary aspects of women’s health and need to be accurate and protected.

The technical project aims to understand and measure the migration of breast cancer biopsy clips. When a patient receives a mammogram, if there is a spot on the image that looks suspicious, a small sample is removed and sent for a biopsy and a clip is left in its place. These clips serve two purposes. If the biopsy is negative, they act as a future reference for physicians. If the tissue is abnormal, they serve as a marker for tumor removal. Currently, the two main options for biopsy clips are titanium ones which require a secondary procedure to localize the tumor during surgery or hydrogel surrounded clips which can be localized with ultrasound in an operating room. Hydrogel clips tend to migrate when the tissue decompresses, which reduces surgical accuracy and worsens lumpectomy margins. Using bovine tissue as an ex vivo model for human breast tissue, we designed a compression device to mimic a mammogram. We created titanium wire coils and deployed them under X-ray guidance into the tissue using hollow needles to mimic biopsy clip insertion. Overall, these clips did not migrate significantly, meaning the data is an appropriate negative control for clip migration. This project was limited by the unavailability of hydrogel biopsy clips, preventing their migration from being studied. Future studies should apply the outlined method to evaluate hydrogel clip migration and inform redesigns that minimize it.

The overturning of Roe v. Wade in Dobbs v. Jackson marked a critical shift in reproductive healthcare access, reflecting the destabilization of a previously established network of policies, technologies, and advocacy efforts. This STS research investigates how the presence of women in positions of power influenced public and political discourse surrounding reproductive healthcare in the lead-up to Dobbs v. Jackson. Specifically, it asks: How did women in positions of power contribute to the destabilization of the network of reproductive healthcare technologies that lead to Dobbs. v. Jackson? This study explores how women in leadership positions influenced policies and public discourse surrounding abortion rights, contraceptive access, and funding for reproductive health services. Actor-Network Theory (ANT) provides a lens to examine the interactions between key actors—healthcare workers, policymakers, religious leaders, and educators—and the actants of abortion, birth control, and legislation. The discourse leading up to Dobbs suggests that while women in power played a role in both defending and restricting access, institutional and political factors often limited their ability to stabilize the network. Early findings suggest that evolving relationships among stakeholders contributed significantly to the broader destabilization of reproductive healthcare access.