Guidance in breast-conserving surgery: tumour localization<i>versus</i>identification

Kedrzycki, Martha; Elson, Daniel S.; Leff, Daniel

doi:10.1093/bjs/znac409

Cited by 4 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3F ), also identified to have the highest immunohistochemistry (IHC) score for HER2 over-expression (Table EV2 ). Thus, in line what has been suggested in literature (Kedrzycki et al, 2022 ), our results indicate that for more heterogenous tumor types like BC, probe combinations might be required to reach sufficient coverage across patients. Exploiting the scalability of our platform, we used it to screen 6 single probes and 57 probe combinations in total (Figs.…”

Section: Resultssupporting

confidence: 91%

“…EV5 ). Together, this addresses a current clinical challenge (Kedrzycki et al, 2022 ), by identifying two sets of probe combinations for further follow-up in BC. Moreover, it underscores the importance of modeling tumor heterogeneity in target expression and large-scale multiplex screening to identify FGS probes and probe combinations for heterogeneous tumor types.…”

Section: Resultsmentioning

confidence: 97%

See 1 more Smart Citation

A multispectral 3D live organoid imaging platform to screen probes for fluorescence guided surgery

Jeremiasse,

van Ineveld,

Bok

et al. 2024

EMBO Mol Med

View full text Add to dashboard Cite

Achieving complete tumor resection is challenging and can be improved by real-time fluorescence-guided surgery with molecular-targeted probes. However, pre-clinical identification and validation of probes presents a lengthy process that is traditionally performed in animal models and further hampered by inter- and intra-tumoral heterogeneity in target expression. To screen multiple probes at patient scale, we developed a multispectral real-time 3D imaging platform that implements organoid technology to effectively model patient tumor heterogeneity and, importantly, healthy human tissue binding.

show abstract

Section: Resultssupporting

confidence: 91%

Section: Resultsmentioning

confidence: 97%

A multispectral 3D live organoid imaging platform to screen probes for fluorescence guided surgery

Jeremiasse,

van Ineveld,

Bok

et al. 2024

EMBO Mol Med

View full text Add to dashboard Cite

show abstract

“…There is an overwhelming need to improve precision during BCS, 10 , 44 – 47 but current localizing techniques are unable to provide surgeons with sufficient information to guarantee entire tumor removal. 12 Eliminating the need for a second surgery would benefit patients, alleviating psychological stress, reducing complications, and improving cosmetic outcomes and quality of life. In addition, the hospital would benefit from decreased use of resources, improved workflow, and by negating the costs of a re-operation.…”

Section: Discussionmentioning

confidence: 99%

“… 10 Although certain reports have demonstrated a reduction of 10% to 30% in positive margins when compared to palpation guided surgery, they only provide approximate guidance for localization of the center of the tumor. 6 , 10 – 12 The necessity for innovative techniques to revolutionize localization and reduce re-operation rates has led to the development of fluorescence-guided surgery (FGS), a technique that utilizes specialist imaging systems in combination with fluorescent probes to visualize malignant tissue intraoperatively ( Fig. 1 ).…”

Section: Introductionmentioning

confidence: 99%

Fluorescence guided surgery imaging systems for breast cancer identification: a systematic review

Kedrzycki,

Chon,

Leiloglou

et al. 2024

J. Biomed. Opt.

View full text Add to dashboard Cite

Breast-conserving surgery (BCS) is limited by high rates of positive margins and re-operative interventions. Fluorescence-guided surgery seeks to detect the entire lesion in real time, thus guiding the surgeons to remove all the tumor at the index procedure.Aim: Our aim was to identify the optimal combination of a camera system and fluorophore for fluorescence-guided BCS.Approach: A systematic review of medical databases using the terms "fluorescence," "breast cancer," "surgery," and "fluorescence imaging" was performed. Cameras were compared using the ratio between the fluorescent signal from the tumor compared to background fluorescence, as well as diagnostic accuracy measures, such as sensitivity, specificity, and positive predictive value.Results: Twenty-one studies identified 14 camera systems using nine different fluorophores. Twelve cameras worked in the infrared spectrum. Ten studies reported on the difference in strength of the fluorescence signal between cancer and normal tissue, with results ranging from 1.72 to 4.7. In addition, nine studies reported on whether any tumor remained in the resection cavity (5.4% to 32.5%). To date, only three studies used the fluorescent signal for guidance during real BCS. Diagnostic accuracy ranged from 63% to 98% sensitivity, 32% to 97% specificity, and 75% to 100% positive predictive value. Conclusion:In this systematic review, all the studies reported a clinically significant difference in signal between the tumor and normal tissue using various camera/ fluorophore combinations. However, given the heterogeneity in protocols, including camera setup, fluorophore studied, data acquisition, and reporting structure, it was impossible to determine the optimal camera and fluorophore combination for use in BCS. It would be beneficial to develop a standardized reporting structure using similar metrics to provide necessary data for a comparison between camera systems.

show abstract

Technologies and techniques to improve precision in breast conserving surgery

Leff

2024

Journal of Surgical Oncology

View full text Add to dashboard Cite

Imprecision in breast conserving surgery results in high rates of take back to theatre for reexcision of margins. This paper reviews the various approaches to improving the precision of oncological margin control in breast conserving surgery. The review describes the rationale for improved tissue characterization over tumor localization and explores technology‐free approaches, as well as progress being made to develop and test innovative technological solutions.

show abstract

Guidance in breast-conserving surgery: tumour localizationversusidentification

Cited by 4 publications

References 18 publications

A multispectral 3D live organoid imaging platform to screen probes for fluorescence guided surgery

A multispectral 3D live organoid imaging platform to screen probes for fluorescence guided surgery

Fluorescence guided surgery imaging systems for breast cancer identification: a systematic review

Technologies and techniques to improve precision in breast conserving surgery

Contact Info

Product

Resources

About