Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery.

Breast Cancer Res 2018 07 9;20(1):69. Epub 2018 Jul 9.

School of Physics and Astronomy, University of Nottingham, Nottingham, NG7 2RD, UK.

Background: In over 20% of breast conserving operations, postoperative pathological assessment of the excised tissue reveals positive margins, requiring additional surgery. Current techniques for intra-operative assessment of tumor margins are insufficient in accuracy or resolution to reliably detect small tumors. There is a distinct need for a fast technique to accurately identify tumors smaller than 1 mm in large tissue surfaces within 30 min.

Methods: Multi-modal spectral histopathology (MSH), a multimodal imaging technique combining tissue auto-fluorescence and Raman spectroscopy was used to detect microscopic residual tumor at the surface of the excised breast tissue. New algorithms were developed to optimally utilize auto-fluorescence images to guide Raman measurements and achieve the required detection accuracy over large tissue surfaces (up to 4 × 6.5 cm). Algorithms were trained on 91 breast tissue samples from 65 patients.

Results: Independent tests on 121 samples from 107 patients - including 51 fresh, whole excision specimens - detected breast carcinoma on the tissue surface with 95% sensitivity and 82% specificity. One surface of each uncut excision specimen was measured in 12-24 min. The combination of high spatial-resolution auto-fluorescence with specific diagnosis by Raman spectroscopy allows reliable detection even for invasive carcinoma or ductal carcinoma in situ smaller than 1 mm.

Conclusions: This study provides evidence that this multimodal approach could provide an objective tool for intra-operative assessment of breast conserving surgery margins, reducing the risk for unnecessary second operations.

Download full-text PDF

Source
https://breast-cancer-research.biomedcentral.com/articles/10
Publisher Site
http://dx.doi.org/10.1186/s13058-018-1002-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038277PMC
July 2018

Publication Analysis

Top Keywords

breast conserving
12
tissue surfaces
8
large tissue
8
conserving surgery
8
raman spectroscopy
8
intra-operative assessment
8
breast tissue
8
tissue
7
breast
6
optimally utilize
4
utilize auto-fluorescence
4
ductal carcinoma
4
tissue algorithms
4
algorithms developed
4
carcinoma ductal
4
developed optimally
4
guide raman
4
measurements achieve
4
achieve required
4
required detection
4

Similar Publications