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Breast cancer ‘gamechanger’

More than 100 people with breast cancer across Melbourne’s west are among the first public patients in Australia to benefit from an innovative technology that has been lauded as a “gamechanger” for breast cancer surgery.

Sunshine Hospital is first public hospital in the state to use Scout, a small insertable device that streamlines the surgical removal of hard-to-feel tumours.

In late 2023, the hospital introduced it using ultrasound and mammogram, in a joint initiative between its breast surgery and medical imaging teams.

A year later, it became the first public hospital in the country to offer MRI-guided Scout placement, further enhancing accuracy.

Scout is a tiny reflector that can be directly inserted into small, hard-to-feel breast tumours.

Once inserted, the device emits a radar signal that is easily detectable by a hand-held device during surgery.

In pinpointing the precise location of the tumour for the surgeon, it improves accuracy of the procedure, and therefore outcomes for patients.

According to Breast Imaging director and radiologist Dr Joseph Paiva, the device’s introduction has been ground-breaking for patients and surgeons alike.

“Many of these cancers, they’re very small so they can’t be felt by the surgeon. We detect them through ultrasounds or MRI and we need to be able to precisely allow them to be located during surgery but there needs to be a way of guiding surgeons to it,” he said.

“Previously, that was done with a metallic wire which was put in before surgery.

“It wasn’t very nice. We didn’t like doing it and the patients generally didn’t like it either.”

Inserting the hook wire requires multiple procedures on the day of surgery and can be uncomfortable for patients, with part of the wire remaining outside of the breast.

“It’s not a great experience, but that was pretty much the gold standard all over the world up until recently,” Dr Paiva said.

He said Scout had huge benefits on multiple fronts.

“The patient has less anxiety on the day of surgery, and it’s just a better patient experience overall,” he said.

“We’re just excited that we can offer this in the public sector to the women of the west because it’s a great technology.”

Breast surgeon Dr Sophie Nightingale, who led the introduction of Scout to Western Health, agreed with her colleague.

She said Scout was of particular benefit when pre-surgery chemotherapy had been successful in reducing the size of tumours.

“Many patients now have chemotherapy before surgery, because there is better survival, so cancers are shrinking, or even disappearing, with treatment so Scout is more useful than ever,” Dr Nightingale said.

“It can be placed before chemotherapy starts, so no extra procedures are required before surgery.

“So far, the patients have all been very happy with the new technology, and we haven’t had any instances where the localisation has failed.”

Since Scout was introduced at Sunshine Hospital in October 2023, more than 110 procedures have been performed.

Among the patients to benefit from this technology is 71-year-old Marie Considine, who had her breast cancer removal surgery in November.

“I’m very glad I didn’t have to have a wire put in, that sounds so scary,” she said.

“I am so grateful that Scout was used instead because it was a really good experience, it didn’t hurt – you don’t really feel like it’s inside you.

“It was a smooth, seamless and quick procedure, all in all my surgery went quite well.”

Sunshine Radiology nurse unit manager Warren Gooch said this is a common response among patients.

“It’s so much better for our patients. It’s a great step forward. Scout has simplified the day of surgery for all parties,” he said.

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