In vivo Margin Assessment during Partial Mastectomy Breast Surgery Using Raman Spectroscopy

Abstract

We present the first demonstration of in vivo collection of Raman spectra of breast tissue. Raman spectroscopy, which analyzes molecular vibrations, is a promising new technique for the diagnosis of breast cancer. We have collected 31 Raman spectra from nine patients undergoing partial mastectomy procedures to show the feasibility of in vivo Raman spectroscopy for intraoperative margin assessment. The data was fit with an established model, resulting in spectral-based tissue characterization in only 1 second. Application of our previously developed diagnostic algorithm resulted in perfect sensitivity and specificity for distinguishing cancerous from normal and benign tissues in our small data set. Significantly, we have detected a grossly invisible cancer that, upon pathologic review, required the patient to undergo a second surgical procedure. Had Raman spectroscopy been used in a real-time fashion to guide tissue excision during the procedure, the additional reexcision surgery might have been avoided. These preliminary findings suggest that Raman spectroscopy has the potential to lessen the need for reexcision surgeries resulting from positive margins and thereby reduce the recurrence rate of breast cancer following partial mastectomy surgeries. (Cancer Res 2006; 66(6): 3317-22)

Raman active components of skin cancer

“…Recent advances in near-infrared lasers, optical filters, fiber optics and CCD cameras have greatly improved its sensitivity in detecting the chemical composition of biological tissues. In the most recent decade, the Raman optical fiber probe has allowed for fast and accurate cancer diagnostics, including ex vivo study of breast [4,5], prostate [6], lung [7] and skin [8,9], and in vivo study of breast [10], cervical [11], and skin [2,12]. Recent clinical studies from our group [12] and others [2] have demonstrated that RS has high diagnostic accuracy in discriminating skin melanoma from nonmelanoma pigmented lesions.…”

Highly Accurate Detection of Cancer In Situ with Intraoperative, Label-Free, Multimodal Optical Spectroscopy

“…RS provides vibrational molecular information based on inelastic light scattering from molecular species, including amino acids, lipids, proteins, and nucleic acid. It has been used in a variety of surgical oncology applications by exploiting the differences between spectroscopic molecular information inherent in normal tissues and cancers such as breast cancer (15), bladder cancer (16), brain cancer (7), precancerous cervical lesions (17), and gastrointestinal cancer during endoscopy (18). IFS detects endogenous fluorophores, including enzymes, metabolic cofactors, amino acids, porphyrins, and structural proteins.…”

“…In vivo RS has been shown to be a highly specific and sensitive cancer detection method for multiple pathologies with detection accuracy values usually limited to approximately 90% (7,(15)(16)(17)30), while oncology applications using IFS and/or DRS have been similarly limited (26,28,29,31). We hypothesized that IFS and DRS have the potential to synergistically complement the molecular information provided by RS to maximize cancer detection capability.…”

Raman spectroscopy can differentiate malignant tumors from normal breast tissue and detect early neoplastic changes in a mouse model

“…Thus, Raman spectroscopy is likely to be a useful technique. [1][2][3][4][5][6][7][8][9][10][11] The objectives of this study were to evaluate the sensitivity and specificity of Raman spectroscopy in differentiating between cancer and normal breast tissue in a mouse model.…”