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Breast cancer surgery world first

A world-first clinical trial to test new imaging technology that can scan tumours during breast cancer surgery has been launched at Guy’s Hospital in collaboration with King’s College London.

Two imaging devices are being tested to see if they will help surgeons remove breast tumours and cancerous lymph nodes without unnecessarily cutting out healthy tissue.

“We hope this is a major development in cancer surgery – we’re taking two steps forward, not just one,” says Professor Arnie Purushotham, a surgeon and cancer researcher at Guy’s and St Thomas’ and King’s College London, and Director of King's Health Partners Integrated Cancer Centre, who is leading the study.

“It should greatly improve surgical accuracy, which is desperately needed because around a quarter of breast cancer patients who have a lump removed need a second operation to remove cancer cells missed in the first surgery.

“Another exciting step is that we will also be scanning lymph nodes, which are often removed during breast cancer surgery. If we can tell on-the-spot which lymph nodes can be safely left, it will improve survivors’ quality of life by reducing the chance of them developing lymphoedema, which is painful swelling in their arm that can last for the rest of their life. The number of breast cancer survivors is expected to rise significantly in the next decade, so this is hugely important.”

After a breast tumour is removed, it is tested to check that all the cancer cells have been successfully extracted. If any are found close to the surface of the tissue that has been cut out the patient has to have a second operation to remove more tissue. The test results can take up to a week to come back, which means patients have an anxious wait before being given the ‘all clear’ or being told they need more surgery. 

In the UK:

  • 50,000 women, and a small number of men, are diagnosed with breast cancer every year
  • Around 65% will survive for 20 years or more. 

There are many potential benefits for both patients and the NHS. If the clinical trial works as expected, patients will have peace of mind that their cancer surgery is likely to be successful first time around and the next stage of their cancer treatment, chemotherapy or radiotherapy, won’t be delayed.

It will also free up NHS theatres to treat more patients so waiting lists should be reduced. The imaging technology has good potential to be extended to surgery for other cancers.

The two new devices being trialled are based on Cerenkov Luminescence Imaging. The red area in the image shows where tumour cells are on the surface of the removed tissue.

The two-year study is a collaboration between Guy’s and St Thomas’ NHS Foundation Trust, King’s College London, and Lightpoint Medical, a medical device company specialising in molecular imaging technology for image-guided surgery. It is funded by two grants from the Technology Strategy Board, the UK’s innovation agency.