New cutting-edge imaging equipment is helping to reduce the need for repeat surgeries by supporting surgeons at St Andrew’s War Memorial Hospital to remove breast cancer with greater precision.
The technology, made possible by the generosity of a donor, allows immediate x-rays of breast tissue in the operating theatre, giving surgeons instant feedback to assess whether they have removed the cancerous tissue along with enough normal surrounding breast tissue.
St Andrew’s breast surgeon, Dr Ben Green, said the ultimate goal is to remove the cancer with clear margins in order to give patients the best possible chance of avoiding recurrence.
Traditionally, breast tissue removed during surgery would be sent to radiology for x-rays, with surgeons having to wait, often in real time, for results before deciding whether further tissue needs to be removed.
“Now we have control of that process in the operating theatre. We can take the x-ray ourselves, on the spot, and see what we have removed,” Dr Green said.
This advancement is helping to reduce scenarios where patients are sent home after surgery, only to be told days later that more tissue needs to be removed.
“We can assess during the surgery if we need to take more breast tissue, giving us the opportunity to do that then and there,” he said.
Repeat surgeries are not only emotionally and physically taxing for patients, but they can also delay essential follow-up treatments such as chemotherapy.
Evidence suggests that for every 12 women having breast lumpectomy surgery where the surgeon utilises intraoperative x-ray, one woman will be spared from re-excision surgery*.
St Andrew’s breast surgeon, Dr Beth Campbell, said the greatest advantages of the technology are for patients.
“It also helps us to avoid removing unnecessary breast tissue ‘just in case’, which is important because the more tissue that is removed, the more difficult it can be to reconstruct the breast later on,” Dr Campbell said.
“Removing breast tissue is a fine balance. We want to ensure we take enough to remove the cancer with the aim of avoiding future recurrence, but we also want to avoid leaving the patient with breast deformities post-surgery,” she said.
In combination with the hospital’s existing Savi Scout surgical guidance equipment, technology is helping to transform the way some breast cancers are removed, while enhancing the experience of the patients we care for.
There are practical and financial benefits too. Fewer operations and additional x-rays can help to reduce out-of-pockets costs for patients.
“We also can save time in theatre and make room for another patient’s surgery,” Dr Green added.
“Ultimately, it gives us greater control and supports us to ensure we’re always working towards the best possible result for our patients,” he said.
Pictured left to right: St Andrew’s breast care nurses, Sophie and Catherine, and breast surgeons Dr Ben Green and Dr Beth Campbell, welcome new breast imaging technology to St Andrew’s.
*Javed N, Afzal S, Parvaiz MA, Rehman P, Khalid IB. Correlation of intra operative specimen imaging with final histopathology in breast conserving surgery for breast cancer. J Pak Med Assoc. 2024 Feb;74(2):252-263. doi: 10.47391/JPMA.8397. PMID: 38419223.