Making breast cancer surgery safer and more effective

22 May 2017

One of the greatest challenges facing breast cancer surgeons is their own humanity.

Currently, performing a successful lumpectomy relies largely on a surgeon’s ability to feel or see a tumour during surgery. This is a subjective process and unfortunately, up to one in three women are forced to undergo further treatment because some microscopic cancer cells may have been left behind.

Western Australian engineers have joined forces with cancer specialists to start developing a surgical glove fitted with tiny optical fibres that will allow real-time microscopic detection of tumour cells during surgery.

This research is being led by St John of God Subiaco Hospital Director of Breast Cancer Research Unit and Surgical Oncologist Professor Christobel Saunders and The University of WA’s Dr Brendan Kennedy (also an engineer at Harry Perkins Medical Research Institute) and Professor David Sampson. Launched six years ago, the research is bridging the gap between engineering and clinical practice.

“This state-of-the-art technology is based on the principles of Optical Coherence Tomography – a non-invasive imaging test using light waves traditionally used to take cross-section pictures of a retina,” Professor Saunders said.

“As a surgeon I can’t see or feel microscopic disease. This technology provides high-resolution images and we hope it will lead to cleaner surgical margins during breast conservation surgery. It will also significantly reduce the number of repeat surgeries for breast cancer patients and may prove useful in other cancer surgery such as prostate cancer.”

Dr Kennedy said the research team had already undertaken successful clinical studies of this technology using a benchtop unit and a probe. It’s been tested as a ‘thimble’ and they are now focusing on how it can be incorporated into a standard surgical glove for ease of use in the operating theatre.

“Combining this technology into a glove will allow the surgeon to simply ‘swipe’ across the tissue with their finger to generate a high-resolution image,” Dr Kennedy said. “This will detect if any cancer is left behind in the breast after the lump has been removed.”

Breast cancer affects one in eight women in Australia and approximately 1.6 million women worldwide are diagnosed each year. While these figures are staggering, Professor Saunders said ongoing research into drugs, detection and supportive care had led to a significant improvement in cure rates and less side effects from treatment.

“In the 1980s we were curing about 70 per cent of women,” Professor Saunders said.

“In the developed world this is now sitting at about 90 per cent, but we believe we can push the envelope a bit further.”

Professor Saunders’ research team has been key in developing an instrument to deliver intraoperative radiotherapy to patients during an operation, which means many women no longer have to endure a five-week course post-surgery. This latest collaboration with the ‘engineering department’ is another example of innovative research that will improve the mortality rate in breast cancer patients.

“This colliding of different disciplines is one of the great joys of research,” she said.

St John of God Foundation Chief Executive Officer Nick Harvey said the Foundation aims to support research projects like the surgical glove, that uses cutting edge technology and medical innovation to provide the best possible heath outcomes to our patients and the community.