In a new study, researchers have developed a new way to more accurately detect breast cancer in patients undergoing breast-conserving surgery.
The study will strongly impact the way surgeons are able to detect microscopic traces of tumors that could previously not be detected by sight, touch or even X-ray imaging during surgery.
The research was conducted by a team from The University of Western Australia and elsewhere.
In the study, the team combined an imaging technique that used light waves to generate three-dimensional images of tissue, optical coherence tomography, with one that produced three-dimensional maps of tissue elasticity, micro-elastography.
Cancer cells are stiffer than benign tissue and by measuring the elasticity of the tissue, the team could more accurately detect cancer cells surrounding the area where the tumor was removed.
The team says beyond surgeons’ native senses of sight and touch, X-rays were often used during surgery to detect tumors within the margins of the area being removed.
While useful in some cases, this method can’t detect small microscopic traces of tumor that surgeons often miss.
As a result, it is widely accepted that higher resolution intraoperative detection techniques are needed.
The study assessed 90 patients undergoing surgical treatment for breast cancer.
Following surgery, the two imaging techniques were used simultaneously to attempt to detect the presence of cancer within the surgical margins before they were submitted for standard pathological processing.
The sensitivity and specificity were then calculated for both imaging methods.
The study showed that the micro-elastography technique developed by the research team was significantly more accurate than optical coherence tomography alone in detecting the presence of cancer cells within the surgical margins.
The team that while numerous emerging imaging techniques had been proposed, such as optical coherence tomography, they had typically been demonstrated on the gross tumor from mastectomy specimens that were often easy to detect with the naked eye.
This study focused on the more clinically relevant and harder to detect the case of the tumor at the edges of breast-conserving surgery specimens.
The technique had the potential to strongly reduce re-excision rates in breast-conserving surgery and remove the subjectivity that was inherent to the surgeon’s sense of touch.
Next, the team hopes to perform the imaging during surgery and immediately after cancer has been removed to give surgeons a direct indication of whether any tumor has been missed.
The lead author of the study is Professor Christobel Saunders from UWA’s Medical School.
The study is published in Cancer Research.
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