Background
Widespread use of mammographic screening has led to increased detection of small, impalpable breast lesions requiring biopsy. BI-RADS 5 lesions require surgical excision regardless of histology. Traditionally, the pathway requires two procedures: image-guided biopsy and preoperative localisation, typically with a hookwire. This model contributes to anxiety, logistical stress and patient discomfort. SCOUT® radar localisation enables device placement at the time of biopsy, offering a streamlined, patient-centred approach that eliminates the need for a second hospital visit. We evaluated the feasibility, accuracy, and value-based care potential of this “one-stop” method.
Methods
A retrospective review was performed for all patients with impalpable BI-RADS 5 lesions who received SCOUT placement at the time of biopsy between October 2023 and June 2025. Data from electronic medical records and imaging systems were used to assess migration, surgical outcomes, and logistical impact. A total of 18 SCOUT markers were placed at the time of biopsy: 11 under ultrasound, 2 mammographically, and 5 with MRI. The SCOUT device was well tolerated and inserted using standard clip placement techniques. All placements were technically accurate with no migration. All markers were retrieved at surgery, with 100% achieving clear margins.
Impact on practice
No patient required a second hospital visit for localisation, reducing logistical burden and procedural anxiety. This device offers significant benefits, including eliminating the need for an initial clip and a second radiology procedure, enhancing theatre scheduling and efficiency. These advantages easily offset its $500 cost.
Discussion
Same-day SCOUT placement is a safe, effective, and patient-friendly alternative to traditional breast localisation workflows. It reduces procedural burden, minimises anxiety associated with multiple hospital visits, and improves care continuity. From a value-based care perspective, this approach streamlines service delivery and offers potential cost savings. It is especially suited to screening-detected cancers and could be expanded to neoadjuvant settings.