WIRE-FREE BREAST SURGERY

What is wire-free breast surgery?

Non-palpable breast abnormalities need to be localised prior to surgical removal. 

The traditional method is with wire localisation. During wire localisation, a hooked wire is inserted into the breast to mark the location of the tumour. Because the end of the wire sticks out from the breast, it is placed on the day of surgery. There is often waiting time from wire placement at radiology to surgery. During this time, you must restrict your arm movement so that the wire is not accidentally dislodged and you may experience discomfort from the wire (when local anaesthetic wears off). At time of surgery, your surgeon follows the wire to find and remove the tumour. 

The SAVI SCOUT technology offers a more comfortable and convenient method of localisation without wires. SCOUT works by placing a tiny device, about the size of a grain of rice (known as reflector), into the tumour. The system then uses safe, non-radioactive radar waves to detect the reflector's location within the breast. The reflector is completely passive until activated in the operating room, when the SCOUT system is used to locate and remove both the tumour and the reflector.

SCOUT has been around since 2016 and is widely used in the USA. Dr Ling has incorporated this technology to her practice on the Central Coast.

What are the advantages of wire-free breast surgery using SCOUT? 

• The ability to insert the SCOUT reflector on a separate day can simplify your day of surgery. It will eliminate the waiting time between wire placement in radiology and surgery. 

• The SCOUT reflector is not externally visible after placement. You will not feel the reflector after it has been placed and you can resume normal activity without the risk of dislodgement.

• Your surgeon is able to choose the best incision for surgery, which can help in a better aesthetic result. With wire localisation, the wire entry site is chose by the radiologist based on ease of access, which may not be the ideal surgical approach. 

• SCOUT provides real time direction and proximity guidance to the reflector, which may mean more accurate removal of the tumour.

• If you need chemotherapy prior to surgery (neoadjuvant chemotherapy), the SCOUT reflector acts as both a 'marker' for the tumour and 'localiser' at time of surgery, eliminating the need for a second procedure. Traditionally, a clip is placed into the tumour to mark its location before chemotherapy and then a wire is inserted on day of surgery to localise the clip. 

What are the disadvantages of wire-free breast surgery using SCOUT?

• The reflector contains nickel, so it is contraindicated if you have a known nickel allergy. 

• Deactivation of the reflector can occur if it comes into contact with electrocautery at time of surgery. Practically, this is not a major issue because the target tissue would have been reached by then. 

• SCOUT reflectors cost more than wires. However, in the setting of neoadjuvant chemotherapy the cost may be neutral as you may not require a second procedure.

More details can be found in the SCOUT Patient Brochure.