New Scanner Halves Repeat Breast Cancer Surgeries

A revolutionary new medical scanner is dramatically reducing the need for repeat surgeries in breast cancer patients. According to the landmark BrIMA study published in JAMA Surgery, the AURA 10® specimen PET-CT scanner increases the chance of removing all tumor cells in a single operation from 23% to 77% for certain forms of breast cancer, effectively halving the number of repeat surgeries required.

The Problem of Repeat Surgeries

In Belgium, 10,000 to 12,000 women are diagnosed with breast cancer annually, with approximately 60% eligible for breast-conserving surgery. Currently, one in five women who undergo this procedure requires a second operation because cancer cells remain at the surgical margins.

“The surgeon cannot see those microscopic cancer cells during the operation,” explained Dr. Göker Menekse, oncological gynecologist and lead researcher at UZ Gent, as reported by HLN. “This makes it a delicate balancing act: removing enough tissue to get all cancer cells, but preserving as much of the breast as possible for a good cosmetic result.”

The current standard involves sending excised tissue to pathology—a process taking one to two weeks. If margins are positive, the risk of local recurrence rises from 7% to 27%. Repeat surgeries mean additional anesthesia, increased complication risk, more scar tissue, and potential delays in starting adjuvant treatments.

How the Technology Works

The AURA 10® is a compact, mobile PET-CT scanner developed by XEOS, a spin-off of Ghent University Hospital and Ghent University. Patients receive a low-dose radioactive sugar solution intravenously hours before surgery. Tumor cells, having higher metabolic activity, absorb more sugar and “light up” on the scan. After tumor excision, the specimen is scanned in the operating room in approximately 10 minutes.

Vincent Keereman, Founder and CEO of XEOS, told XEOS News that “the most important finding from BrIMA is that surgeons gained additional insight at the exact moment they needed to make a decision. Too often, positive margins are discovered only after surgery is complete and the opportunity to act has passed.”

The radiation dose is approximately one-fifth of a classical PET scan and comparable to a single mammogram. Dr. Menekse emphasized that “there are no disadvantages for patients. The surgery does not take longer and there was no risk of additional complications.”

Study Results by Cancer Type

The BrIMA study, conducted across six hospitals in Belgium, Germany, and Italy with 148 women between June 2022 and March 2025, showed dramatic improvements across all breast cancer subtypes:

• Invasive Ductal Carcinoma (most common, 80% of cases): Success rates rose from 83.3% to 95.2%
• Invasive Lobular Carcinoma: Success rates rose from 63% to 88%
• Ductal Carcinoma In Situ (DCIS) (early stage): Success rates rose from 23% to 77%
• All subtypes combined: Success rates improved from 76.4% to 91.9%

Overall, the number of women needing a second operation dropped from 20% to 10%. At UZ Gent specifically, this fell to just 5%.

Patient Impact and Broader Applications

“For our patients, this is a major step forward because they immediately get more certainty about whether their surgery was successful,” said Prof. Dr. Marian Vanhoeij, breast surgeon and coordinator of the Breast Clinic at UZ Brussel, as noted by Think Pink Belgium. “In an oncoplastic procedure, where the breast is immediately reconstructed, it is even more important to remove the tumor completely at once because a reoperation is more difficult.”

Dina De Haeck of Think Pink Belgium added: “Thanks to this Ghent innovation, the operating table for many women with breast cancer will hopefully also become the place where it becomes definitively clear that the battle against the tumor has been successfully won.”

The technology is already being used for head and neck tumors, with research ongoing for prostate, cervical, and vulvar cancers. Each scanner costs approximately €300,000, and XEOS recently raised €14 million from Flemish investors. The system is already active in seven European countries and the United States.

Looking Ahead

While the results are promising, Dr. Menekse cautioned that “the number of patients with DCIS in this study was limited. Further research is still needed to confirm those findings.” Future developments include AI integration for faster and more accurate image interpretation, which could further reduce the need for specialized nuclear medicine expertise in the operating room.

As reported by ASCO Post, the study investigators concluded that “the use of this integrated approach might lead to a substantial reduction of re-excision rates after breast-conserving surgery.” The technology represents a significant step toward making the operating room the place where surgical success is confirmed—not just hoped for.