Reducing Repeat Breast Cancer Surgery with New Imaging Technology

Reducing Repeat Breast Cancer Surgery with New Imaging Technology

By Staff.

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.”

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Authored by: Staff

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Jean Price

Michael…sadly I don’t see this happening with our new doctors or new nurses! They are being almost indoctrinated to believe opioids themselves are an EVIL problem…without much concern for how they help pain or that it’s the person’s choice to abuse them…or use them to compliantly, under close supervision and followup, for pain control and to function better!

My son in law recently graduated from nursing school at Duke, AFTER a career in the Marine Corp…and he seems to be negative about pain medications in general…even confusing the process of addiction with just the chemical changes occurring when using ANY medication long term!! I’ve tried to explain the differences, yet he seems resistant to this truth…and I don’t believe he had such a biased opinion about all of this BEFORE his training! He knows I have used opioids conscientiously and safely for many years, yet he sees me as ADDICTED…although he DID differentiate between me and those who just take drugs illegally “for kicks.”!! However, I think this was mostly because of my surprised, hurt, and outspoken reaction..and his fear of further upsetting me!!

I believe this opioid-phobic mindset is even worse for new doctors, who are also now being cautioned about the liabilities of prescribing without strict limits, when there is so much DEA oversight! Sad state of affairs! I remember as a nurse when the practice of pain care was changed for the better…and we started realizing everyone would need the dosing that helped them…not a one size fits all! And that when opioids were taken for pain, addiction was really a non issue! Even when used long term!

In a few years, we have now turned 180 degrees AWAY from appropriate care and good pain control practices! And I really do wonder if this will change again in my lifetime! I have my doubts, since these changes we’ve seen are clearly not based on science or solid medical information…but rather on the greed and fear and lunacy we see promoted by those in power…the same people who still have the power to go back to reality and help people who are in pain…yet obviously have no motivation or financial incentives to do so! I see our pain care policies and practices now as a national shame!

Michael G Langley, MD

Just when I thought I knew everything?! I never did as do no doctors! New things are discovered all of the time! Sadly, much of the science, is ignored by physicians when it comes to chronic pain management. Doctors are so ignorant of proper pain medicine management that they let someone else decide what is best for their patients! The physician/patient relationship has taken a back seat to the patient/medical committee “relationship” Sadly, committees cannot be intimately involved with patient care unless it is one in an interdisciplinary delivery system. Since most doctors don’t seem to want to learn something new, it is a problem. But, we can only hope and pray that the doctors coming out of medical school start getting more information on caring for chronic pain patients.

Jean Price

Any process that helps surgeons remove the whole tumor has to be a plus! With cancers being found earlier due to mammograms and 3 D mammograms, this is really important. The tumors are small yet can already be invasive. Not only is a second surgery likely prevented when the whole tumor is taken out…with the edges of removed tissue coming back clean all around, but I’m guessing recurrence/metastasis of the cancer some ten or twenty years later…or sooner…could also possibly be reduced.

Maybe if the cancer cells react differently enough…this could also be as a diagnostic tool to detect cancer in a mammogram finding or a lump discovered my the patient! That would be great, especially if it prevented the need for multiple needle biospsies, where ten or twelve holes are punched in the tumor (sometimes weeks prior to it being removed)!! I personally never have felt like this was a great idea! It seems highly likely cancer cells would break off during this procedure, and possibly materialize into tumors later on. (Besides the fact that stereotactic breast biopsy is a REALLY uncomfortable procedure!). FYI….My radiologist told me that a single cancer cell can take three years to become another tumor, so followup mammograms are a must after lumpectomies…for early detection of any spread.