Long Term Use of SAVI SCOUT: Pilot Study

The SAVI SCOUT (Cianna Medical, Inc.) surgical guidance system received 510(k) U.S. Food and
Drug Administration (FDA) approval in August 2014. This system is used as a standard of care
since 2015 in the Memorial Healthcare System (MHS) operating rooms by experienced breast
surgeons (over 150 MHS breast cancer patients and over 5,000 U.S. breast cancer patients as
of September 2016). In MHS standard of care practice, the device is placed at the target
lesion(s) under image-guidance by the radiologist up to 30 days prior to surgery.

Patients with certain types of breast cancer undergo neoadjuvant treatment with biologic
(hormonal) and/or chemotherapy with the goal of decreasing the tumor volume prior to
definitive surgery. If the original cancer lesion(s) resolve completely, this is called
complete pathologic response (pCR). pCR and even a partial response, while good for the
patient, can result in disappearance or poor visualization of the target and often render
pre-operative image-guided localization by the radiologist more difficult and less reliable.
This can result in unintended larger, more disfiguring breast cancer surgery. Therefore, if
the SCOUT device can be placed prior to treatment response, when the lesion is clearly
visualized on imaging, accurate image-guided targeting is optimal and thus placement and
subsequent surgery should be more accurate. If this pilot study demonstrates successful
performance of the device without device-related complications, it will bring improved value
to future patients who will require fewer and/or less extensive pre-operative and surgical
procedures. Some value may also be provided to subjects as the targeting before tumor
shrinkage is expected to be more accurate.

Thus, this pilot study will assess the performance of FDA-cleared SCOUT system over a longer
duration prior to breast and/or axillary lymph node surgery.

Inclusion Criteria:

- Patient is willing and able to provide informed consent. Patient SCOUT device(s) is
placed as part of routine care or study but before neoadjuvant treatment begins.

- Patient is female.

- Patient is between the ages of 18 and 90 years.

- Patient has breast cancer and will undergo neoadjuvant therapy and excision at
Memorial Healthcare System.

- Patient is willing and able to comply with all study procedures and be available to
follow-up for the duration of the study (1 - 13 months).

- Patient reads or understands English or Spanish.

Exclusion Criteria:

- Patient is pregnant.

- Patient has pacemaker or implantable defibrillators (These have not been bench tested
as of September 2016).

- Patient has known or suspected nickel allergy.

- Patient is scheduled or receiving investigational drugs for neoadjuvant regimen. (This
could confound UADE of this device.)

- Patient has any condition that would place the individual at increased risk or
preclude the individual's full compliance with or completion of the study.

- Patient has other malignancy except for adequately treated and cured basal or squamous
cancer, curatively treated in situ disease or any other cancer for which the patient
has been disease free for greater than or equal to 5 years.