Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery.
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 detec...
| Publicado en: | Breast Cancer Research Vol. 20; no. 1 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BioMed Central
7/9/2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130594506&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130594506 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14655411 8UYJ jtl: Breast Cancer Research issn: 14655411 maglogo: N pubinfo: dt: 7/9/2018 vid: 20 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 130594506 130594506 NLM29986750 130594506 10.1186/s13058-018-1002-2 NLM29986750 130594506 ppct: 1 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery. aug: au: Shipp, Dustin W. Rakha, Emad A. Koloydenko, Alexey A. Macmillan, R. Douglas Ellis, Ian O. Notingher, Ioan affil: School of Physics and Astronomy University of Nottingham NG7 2RD Nottingham UK sug: subj: Carcinoma, Ductal, Breast Surgery Adenocarcinoma Surgery Breast Neoplasms Surgery Lumpectomy Breast Surgery Neoplastic Processes Surgery Adenocarcinoma Physiopathology Adult Neoplastic Processes Physiopathology Breast Physiopathology Middle Age Human Carcinoma, Ductal, Breast Physiopathology Breast Neoplasms Physiopathology Spectrum Analysis, Raman Female Validation Studies Comparative Studies Evaluation Research Multicenter Studies Clinical Assessment Tools Adult: 19-44 years Middle Aged: 45-64 years Female ab: 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 mm2 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 cm2). 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 mm2.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. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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