New scanning technology that could prevent the removal of healthy tissue during breast cancer surgery has entered clinical trials.
Researchers at Guy's and St Thomas' NHS Foundation Trust and King's College London are examining two imaging devices that can scan tumours during the operation instead of afterwards.
At present, after surgery the removed breast tumours are tested to check that all the cancer cells have been successfully taken out. If any cancer cells are found close to the surface, the patient has to undergo a second operation to ensure that all of the cancer has been removed, but the tests can take up to a week after the initial surgery.
The surgeons hope the new technology could help remove breast tumours and cancerous lymph nodes without unnecessarily cutting out healthy tissue as well as preventing the anxious wait that patients have to endure before finding out whether or not they need more surgery.
"We hope this is a major development in cancer surgery," said lead study author Professor Arnie Purushotham, a surgeon and cancer researcher at Guy's and St Thomas' and King's College London.
"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.
"The number of breast cancer survivors is expected to rise significantly in the next decade, so this is hugely important."
Experts are testing two new devices, which were developed by Lightpoint Medical, which see patients injected with a small amount of a radioactive substance that "tags" the tumour cells.
The first device, the LightPath specimen analyser, uses the positron emission tomography (PET) imaging technique to detect any cancer cells tagged with the marker on the tumours surface in just a few minutes, which means the test can be done in the operating theatre during the initial surgery so any additional surgery needed can be done then and there.
The other device undergoing trials is the EnLight molecular imaging fibrescope – a flexible fibre optic camera that can scan inside the breast for the radioactive markers using Cerenkov luminescence imaging and beta particle imaging.
After a tumour has been surgically removed, medics will use the device to check that none of the remaining breast tissue is tagged, allowing them to make a decision on additional surgery while still in the operating theatre.
"There are so many potential benefits for both patients and the NHS. If this clinical trial works as we hope, 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,” said Purushotham.
"It will also free up NHS theatres to treat even more patients so waiting lists should be reduced. It's a win-win situation all round, especially as it has good potential to be extended to surgery for other cancers."
Lightpoint Medical hopes the specimen analyser will receive regulatory approval by 2015 and the fibrescope by 2016.