One of the most important lessons I have learned throughout my career is that the accuracy of a surgical procedure is often limited by the quality of the information available to the surgeon. This realization has guided much of my work in medical imaging, image-guided intervention, and technology commercialization. In breast surgical oncology, I became increasingly aware of a persistent challenge facing surgeons performing breast-conserving surgery: the difficulty of accurately localizing tumors and defining their true boundaries during the operation. While advances in imaging had dramatically improved the detection of breast cancer, the information available to surgeons in the operating room often remained incomplete or difficult to translate into precise surgical action. This challenge ultimately became the foundation for the work we pursued at Cairn Surgical.
The goal of breast-conserving surgery is straightforward—to completely remove the cancer while preserving as much healthy breast tissue as possible. In practice, however, achieving this balance can be extremely difficult. Surgeons frequently rely on imaging studies performed before surgery, often using MRI scans acquired with the patient lying prone, or face down. While these images provide excellent diagnostic information, they do not accurately represent the anatomy encountered during surgery, when the patient is positioned supine, or lying on her back. The breast can change shape significantly between these two positions, causing the location of the tumor and surrounding structures to shift. As a result, surgeons are often forced to mentally translate imaging information into the surgical setting, introducing uncertainty into the procedure.
At Cairn Surgical, we asked a simple but powerful question: What if we could provide surgeons with imaging information that matched the patient’s anatomy exactly as it appears during surgery? That question led to the development of our supine MRI-based surgical planning platform. Rather than relying solely on conventional imaging approaches, we developed methods for capturing MRI data with the patient positioned in the same orientation used during surgery. By acquiring images in the surgical position, we were able to create a far more accurate representation of the anatomy that surgeons would actually encounter in the operating room.
The next challenge was determining how to transform this imaging information into something that surgeons could easily use. This effort resulted in one of Cairn Surgical’s most innovative technologies: the Visualizer™. The Visualizer provides surgeons with an interactive three-dimensional representation of the breast, tumor, and surrounding anatomy based on patient-specific supine MRI data. For the first time, surgeons could explore a highly detailed 3D model of the operative field before entering the operating room, gaining a more intuitive understanding of tumor size, shape, and location relative to the patient’s anatomy. Rather than interpreting a series of two-dimensional image slices, they could visualize the tumor within a realistic three-dimensional context.
However, visualization alone was not enough. We wanted to bridge the gap between preoperative planning and intraoperative execution. This led to the development of the Breast Cancer Locator, or BCL™ System. Using the patient’s supine MRI data, we create a customized, patient-specific surgical guide designed to fit the unique contours of that individual’s breast. The device provides physical reference points that help surgeons accurately transfer imaging information directly onto the patient during surgery. By combining advanced imaging, 3D visualization, and personalized surgical guidance, the BCL System significantly reduces the guesswork associated with tumor localization and excision.
What excites me most about this technology is its ability to support truly patient-specific care. Every breast cancer is unique, and every patient’s anatomy is different. Traditional approaches often rely on generalized methods of localization that may not fully account for these individual differences. Our approach begins with the patient’s own anatomy and imaging data, allowing us to create customized surgical plans and guides tailored specifically to that individual. This level of personalization represents an important step forward in precision medicine and image-guided surgery.
The impact of these innovations extends beyond surgical convenience. One of the most significant challenges in breast-conserving surgery is achieving clear margins during the initial procedure. When cancer cells remain at the edge of the excised tissue, patients often require additional surgeries, creating emotional, physical, and financial burdens. By improving tumor localization and surgical planning, our technologies are designed to help surgeons remove tumors more completely during the first operation while minimizing unnecessary removal of healthy tissue. Emerging clinical studies have demonstrated encouraging results, suggesting that supine MRI-guided surgical planning and the BCL System may significantly reduce positive margin rates while improving surgical accuracy.
The development of these technologies also highlights the power of multidisciplinary collaboration. Cairn Surgical emerged from the convergence of engineering, imaging science, clinical medicine, computational modeling, and manufacturing innovation. Creating patient-specific surgical guides requires expertise in MRI acquisition, image processing, 3D modeling, additive manufacturing, software development, and surgical oncology. Throughout my career, I have consistently seen that the most transformative healthcare innovations arise when experts from diverse disciplines work together to solve meaningful clinical problems.
Looking toward the future, I believe breast surgical oncology will become increasingly personalized, data-driven, and image-guided. Three-dimensional visualization, patient-specific planning, advanced imaging, artificial intelligence, and customized surgical guidance systems will continue to reshape how surgeons approach breast cancer treatment. The work we have pursued at Cairn Surgical represents an important step toward that future—a future in which every patient benefits from a surgical strategy designed specifically for her anatomy, her disease, and her individual needs.
Ultimately, our mission has always been simple: to provide surgeons with better information so they can make better decisions. By leveraging supine MRI imaging, interactive 3D visualization, and patient-specific surgical guidance, we are helping transform breast cancer surgery from an experience that often relies on estimation into one grounded in precision, personalization, and confidence. That transformation has the potential to improve outcomes, reduce repeat procedures, and deliver a higher standard of care for patients facing breast cancer.
