A new imaging technology developed by engineers at the Optical Imaging Laboratory could reduce repeat surgeries for breast cancer patients. The technology may help surgeons removing breast cancer lumps confirm that they have removed the entire tumor, which would reduce the need for additional surgeries.
This may be good news for the estimated 225,000 patients newly diagnosed with invasive breast cancer and who undergo breast-conserving surgery, such as lumpectomies, which attempt to remove the entire tumor while retaining as much of the undamaged breast tissue as possible. According to Lihong Wang, who led the team of engineers, about 20 to 60 percent of patients find out that they need another surgery to remove more tissue.
When tissue is removed, it’s sent for testing, which takes about two weeks. When tumor cells are found on the surface of the tissue sample, it indicates the surgeon has cut into the tumor, which means a portion of the tumor remain in the breast and a second surgery will be needed.
“What if we could get rid of the waiting? With 3D photoacoustic microscopy, we could analyze the tumor right in the operating room, and know immediately whether more tissue needs to be removed,” said Wang, who is a Bren Professor of Medical Engineering and Electrical Engineering in Caltech’s Division of Engineering and Applied Science.
The 3D photoacoustic microscopy uses a low-energy laser, which vibrates the tissue and measures the ultrasonic waves coming from the vibrating tissue. The technology reveals the size of the nuclei and cell density. Cancerous tissue have larger nuclei and more densely packed cells.
A paper publishing in the journal Science Advances shows that the technology produces images capable of highlighting cancerous features, with no slicing or staining required.
Wang’s team has focused primarily on breast cancer tumors, but the work has potential applications for any analysis of excised tumors for other cancers.
“Because the device never directly touches a patient, there will be fewer regulatory hurdles to overcome before gaining FDA approval for use by surgeons,” Wang says. “Potentially, we could make this tool available to surgeons within several years.”