Precision Strike: How New OR Tech is Revolutionizing Breast Cancer Surgery

GHENT, Belgium – June 18, 2026 – For thousands of women undergoing breast-conserving surgery each year, the most dreaded news often comes days after the procedure is over: "We didn't get it all." This discovery of "positive margins"—cancer cells left at the edge of the removed tissue—triggers a cascade of physical and emotional distress, culminating in a second surgery. This has long been a persistent and painful challenge in oncology, affecting up to 30% of patients. But a landmark clinical study, published today in the prestigious JAMA Surgery, provides powerful evidence that this era of uncertainty may be drawing to a close.

The study, known as BrIMA, validates a new intraoperative imaging system from Belgian medical technology firm XEOS. Their AURA 10® device, a compact PET-CT scanner for the operating room, provides surgeons with a detailed 3D molecular map of the excised tumor in about ten minutes. The results are stark: surgeons using the system were dramatically better at identifying and removing all cancerous tissue in a single procedure, potentially saving countless patients from the trauma and cost of reoperation.

The End of the "Second Cut"?

Positive surgical margins are the leading cause of reoperation in breast-conserving surgery, a stubborn problem that has plagued oncology for decades. When a pathologist finds cancer cells at the edge of the removed specimen days after the initial operation, the patient must return for another procedure to remove more tissue. This not only doubles the physical recovery time but also heaps emotional anxiety on patients and can delay crucial follow-up treatments like chemotherapy and radiation.

The BrIMA study, the largest prospective evaluation of its kind, demonstrates a significant leap forward in tackling this issue. In the multicenter trial involving 148 patients, the success rate of achieving clean margins during the initial surgery soared. For patients with invasive ductal carcinoma (IDC), the most common type of breast cancer, the success rate jumped from 83.3% without the new imaging to an impressive 95.2% with it. Across all breast cancer subtypes in the study, the rate improved from 76.4% to 91.9%.

"The most important finding from BrIMA is that surgeons gained additional insight at the exact moment they needed to make a decision," said Vincent Keereman, Founder and CEO of XEOS, in a statement. "Too often, positive margins are discovered only after surgery is complete and the opportunity to act has passed. BrIMA demonstrates that specimen PET-CT can provide actionable information while the patient is still in the operating room, enabling surgeons to make more informed decisions when corrective action is still possible." This shift from post-operative hope to intraoperative certainty represents a fundamental change in the standard of care.

A Clearer View in the Operating Room

The AURA 10® system's innovation lies in its ability to combine two powerful imaging technologies—Positron Emission Tomography (PET) and Computed Tomography (CT)—into a mobile unit designed for the surgical workflow. Unlike traditional methods like Frozen Section Analysis (FSA), which involves sending small, selected tissue slices to a lab for a time-consuming microscopic review and is prone to sampling errors, the AURA 10® scans the entire excised specimen in 3D.

The PET component detects the metabolic activity of cancer cells, which are tagged with a radiotracer before surgery, essentially making them glow on the scan. The CT component provides a detailed anatomical map of the tissue. By overlaying these two images, the system generates a high-resolution 3D model that clearly shows surgeons if any cancerous tissue extends to the specimen's edge. This comprehensive, molecular-level view is a world away from two-dimensional or surface-level assessments.

"The BrIMA results demonstrate that specimen PET-CT can provide reliable intraoperative visualization across multiple breast cancer subtypes while integrating effectively into routine surgical practice," noted Dr. Menekse Göker, the study's primary author and a breast surgeon at Ghent University Hospital. The ability to get these results in about ten minutes, without the specimen ever leaving the operating room, is a crucial logistical advantage that distinguishes it from other emerging technologies. This real-time feedback loop empowers surgeons to act with a level of precision that was previously unattainable, embodying a "certainty-first" approach that directly enhances patient safety and outcomes.

The Economic Case for Surgical Precision

Beyond the profound patient benefits, the implications for the business of healthcare are enormous. Reoperations are not just emotionally taxing; they are incredibly expensive. Each repeat surgery consumes valuable operating room time, requires a full surgical team, and incurs costs for anesthesia, hospital stays, and supplies. In an era where healthcare systems are under immense pressure to deliver value and improve efficiency, a technology that can demonstrably reduce a common and costly secondary procedure is a strategic game-changer.

By slashing reoperation rates, hospitals can unlock significant cost savings. More importantly, they can improve operational throughput. An operating room that is not tied up with a preventable second surgery is an OR that can be used for another patient on the waiting list. This optimization of resources—surgeons, nurses, anesthesiologists, and physical infrastructure—is a core objective of modern hospital administration.

Furthermore, quality metrics like reoperation rates are becoming increasingly important for hospital rankings, insurance reimbursements, and patient choice. Investing in technology that directly improves these key performance indicators is not just a clinical decision but a sound business strategy. The data from the BrIMA study provides a compelling case for adoption, transforming the "security-first" mindset of cybersecurity into a "precision-first" doctrine for surgical oncology, where better information directly drives better market and clinical performance.

Validation and the Path Forward

The publication of the BrIMA study in JAMA Surgery, a journal with a stellar impact factor and a rigorous peer-review process, lends immense credibility to the findings. The study's robust design—prospective, interventional, and conducted across six top-tier cancer centers in three different European countries—ensures the results are not an isolated anomaly but are reproducible in real-world clinical settings. With no device-related adverse events reported, the technology has also proven to be safe and reliable.

For XEOS, this publication marks a critical milestone, moving its technology from promising innovation to clinically validated solution. With strong data from a study conducted in Belgium, Germany, and Italy, the company is well-positioned for broader commercial adoption across Europe. The next logical frontier will be the United States, where the high incidence of breast cancer and the focus on value-based care create a significant market opportunity, pending regulatory review by the FDA.

While the immediate focus is on breast-conserving surgery, the underlying technology holds promise for a wide range of other cancers where achieving clean surgical margins is paramount, such as prostate, lung, and head and neck cancers. The success of the BrIMA study provides a powerful foundation for future research and development, suggesting that real-time molecular imaging in the operating room may soon become the standard of care across surgical oncology.