A surgeon at the forefront of the fight against breast cancer has stressed new state-of-the-art equipment will be “absolutely game-changing” in the treatment of the disease.
The Herts Advertiser and its sister title, the Watford Observer, are supporting the West Herts Hospitals Charity’s campaign to raise £200,000 to buy two Savi Scout surgical guidance systems, which use radar technology to precisely target and remove cancerous tissue.
These will be based in the breast unit at St Albans City Hospital, where patients from across West Herts – including Watford – are treated for the disease.
To learn more about the appeal and make a donation, click here.
Around 8,000 patients are seen annually in the unit with a variety of symptoms, including breast pain, breast lumps, nipple discharge, a rash and lumps in the armpit and neck.
This equates to around 120 to 140 patients per week and, of those, an average of seven or eight – around 400 a year – are diagnosed with cancer.
“Out of those 400 cancer patients probably around 40 to 50 per cent of them will have a breast conserving operation,” explained consultant breast surgeon Miss Lee Min Lai.
“It means they don’t have the whole breast removed, they get the part of the breast that has the cancer within it removed. Amongst this group of patients, many of them – more than half – will have cancers that are not easily felt.
“It’s these patients whom we need to have some way of identifying where in the breast the cancer is and have a device to guide us so we can take the cancer out and not miss it. That is the crux of this piece of equipment.
“Currently what we do is, very simply, put a very thin wire into the breast – we call it a guide wire – under local anaesthetic. The radiologist localises the cancer, visualises it on the ultra-sound scan and gets this thin wire and threads it in to skewer the cancer and this guides the surgeon to take it out.
“At the time of the operation we remove the cancer, the wire, the surrounding breast tissue and X-ray it to confirm we’ve got everything out.
“The problem with the wire is it can only be put in within 24 hours of the operation taking place because otherwise you’ll have a wire sticking out and it’s very uncomfortable.”
The Savi Scout works by placing a “tiny little seed” – about the size of a grain of rice – in the tumour and it can be inserted at any point; it doesn’t have to be within 24 hours of surgery.
“It comes with a probe that emits radar and reflects it – it’s like sonar location – and it’s highly accurate,” Miss Lai said. “We’ve tested it and we like it.”
The appeal does not need to reach its full target to buy one Savi Scout – it can be purchased immediately once £100,000 has been raised.
“We thought we could apply for a business case through the trust but were told the trust is very short of money and there are a lot of other competing projects,” Miss Lai said when asked why the appeal was necessary. “We were told it would be considered but we don’t know when we will get this piece of equipment.
“We have been using another type of device but that has now gone out of stock, as in we don’t know if we’re going to even get anymore, so it’s gone from need to becoming urgent and nearly becoming an emergency.”
The manufacturers claim Savi Scout is accurate to within one to two millimetres.
“I can’t, hand on heart, say it will be down to one millimetre but it is accurate enough that we’ve been able to target and remove all the cancers with the implanted device and with good surrounding margins,” said Miss Lai.
“We X-ray what we take out and on the machine you will see the cancer, you’ll see the little seed (reflector) inside the cancer and what you want to see is a little rim of clear tissue around the cancer because that tells you that you’ve cleared it.
“That’s not always easy to assess hence we have pathologists who then look at these things under the microscope, absolutely scrutinise every little nanometre and then tell us whether we’ve got it or not.”
The Savi Scout has other benefits. It can be used in an MRI machine because it is not ferromagnetic and does not obscure the MRI images. It is small enough that it can be inserted into a lymph node and it can also be used to map cancers.
“There’s a group of patients who have certain types of cancers that do better with having chemotherapy first - and the chemotherapy is so good these days it sometimes makes it completely disappear,” said Miss Lai.
“We still need to go back in and take out the footprint of the cancer and we need to leave a little marker so we know where to go, so it can be used in this setting as well. Up to 20 per cent of the new cancers would go for chemotherapy first.”
Describing Savi Scout as “multi-purpose” and “absolutely game-changing for us”, Miss Lai said: “It means we can remove these cancers with significantly more accuracy, with less chance of having to go back in if you get it the first time around.
“The traditional way where we put wires in is much more labour intensive and also it means the patient needs to have it within a certain timeframe and it literally ties you down, whereas this wireless seed can be put in at any point, we are not tied to the 24-hour period or on the day insertion and it makes it so much nicer for the patient as well because they are not having all their appointments bunched up together.
“It makes it a lot easier for us to schedule, it frees up a lot of clinic time and we’re not constantly chasing a slot because it has to be within 24 hours.
“It makes a huge difference for us, it makes a huge difference to the patient journey so these are all plus, plus, plus points.”
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