Imaging of lumpectomy surface with large field-of-view confocal laser scanning microscopy ‘Histolog® scanner’ for breast margin assessment in comparison with conventional specimen radiography

Togawa, Riku; Hederer, J.; Ragazzi, Moira; Brückner, Thomas; Fastner, Sarah; Gomez, Christina; Hennigs, André; Nees, Juliane; Pfob, André; Riedel, Fabian; Schäfgen, B; Stieber, Anne; Lux, Michael P.; Heil, Jörg; Golatta, Michael

doi:10.1016/j.breast.2023.02.010

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…Usually, intraoperative recuts are not analyzed due to the lack of time and resources. This additional assessment has been recently proposed by Togawa et al with the Histolog Scanner thanks to its speed, ease of use, and high specificity [25]. In our study, four cases required justifiable resections by the surgeon due to positive margins on primary lumpectomy.…”

Section: Performance Reviewmentioning

confidence: 60%

“…The consequence of this is a substantial time between the specimen excision and confocal imaging that results in an alteration of the specimen surface at a microscopic level, impeding the quality of Histolog images and therefore the detection rates by physicians. Unfortunately, this finding was not identified at the time of our study, but has been recently reported in a study that also included a round trip of the specimen between radiology and surgery prior to Histolog imaging [25]. Our suggestion is therefore to carry out confocal imaging prior to sending it to the radiology to ensure good image quality, as reported in another study that included an exclusively cold scalpel for specimen excision and rapid ultrasound assessment performed directly in the OR prior to Histolog imaging [21].…”

Section: Limitationsmentioning

confidence: 80%

“…Additionally, the utilization of electrocautery as part of the surgical technique in this study may have impacted the results due to the tissue retraction making it challenging to identify cancerous cells in images, as previously reported [21,25]. In the workflow of this observational study (Figure 2), the specimen was sent to radiology and imaged with the Histolog Scanner after the surgery.…”

Section: Limitationsmentioning

confidence: 97%

“…With this device, sample preparation is rapid and simple. The piece of lumpectomy, freshly removed, is briefly stained and imaged within minutes, without the need for fixation or sectioning to reveal the microscopic morphology of the tissue, as seen in Figure 1 [25,26]. The pathologist, but also the surgeon, can interpret the images in the operating theater [20,26].…”

Section: Introductionmentioning

confidence: 99%

“…So far, confocal microscopy has shown promising results in evaluating the tissue morphology of a specimen and assessing the presence of cancer. In the field of breast cancer, two studies on 50 patients each revealed promising results with the Histolog ® Scanner (Samantree, Lausanne, Switzerland) on lumpectomies, indicating that the image performance allows the detection of breast cancer in fresh human tissue with accuracy and high reliability [21,25]. The present study aims to compare this new and innovative confocal laser microscopy scanner (the Histolog ® Scanner (HS)) with per-operative radiography, our hospital's standard protocol (SoC) for patients with non-palpable breast cancer.…”

Section: Introductionmentioning

confidence: 99%

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SENOSI Confocal Microscopy: A New and Innovating Way to Detect Positive Margins in Non-Palpable Breast Cancer?

Wernly,

Beniere,

Besse

et al. 2024

Life

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In Switzerland, breast cancer is the leading cancer among women, with breast-conserving surgery (BCS) being the preferred treatment for small tumors. The margin status post-surgery is a critical predictor of local recurrence. Achieving negative margins remains a challenge, leading to re-excision in 20–30% of cases. Traditional methods like intraoperative examination palpation and radiography have limitations in assessing excised margins. This study introduces the Histolog® Scanner, a confocal microscopy tool, as a potential solution. It provides real-time images of tissue architecture, allowing for rapid and accurate assessment of excised margins. Our research compared the Histolog® Scanner with standard per-operative radiography in patients with non palpable breast cancer. Preliminary results indicate that the Histolog® Scanner offers a reliable and time-efficient method for margin assessment, suggesting its potential for clinical integration.

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Section: Performance Reviewmentioning

confidence: 60%

Section: Limitationsmentioning

confidence: 80%

Section: Limitationsmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

SENOSI Confocal Microscopy: A New and Innovating Way to Detect Positive Margins in Non-Palpable Breast Cancer?

Wernly,

Beniere,

Besse

et al. 2024

Life

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show abstract

Technologies and techniques to improve precision in breast conserving surgery

Leff

2024

Journal of Surgical Oncology

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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.

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Breast tissue imaging atlas using ultra-fast confocal microscopy to identify cancer lesions

Mathieu,

Ragazzi,

Ferchiou

et al. 2024

Virchows Arch

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New generation ultra-fast fluorescence confocal microscopy (UFCM) allows to image histological architecture of fresh breast tissue and may be used for ex vivo intraoperative analysis for margin status. The criteria to identify breast tumoral and non-tumoral tissues in UFCM images are still objects of investigation. The objective of the study was to create an atlas of ex vivo UFCM images of breast tissues and breast carcinomas based on the first extensive collection of large field-of-view UFCM breast images. One hundred sixty patients who underwent conserving surgery for breast cancer were included. Their fresh surgical specimens were sliced, stained with acridine orange, and imaged at high resolution with large-field-of-view UFCM. The resulting images were digitally false colored to resemble frozen sections. Each UFCM image was correlated with the corresponding definitive histology. Representative images of normal tissue, inflammation, benign lesions, invasive carcinoma (IC), and ductal carcinoma in situ (DCIS) were collected. A total of 320 large-field images were recorded from 58 IC of no special type, 44 invasive lobular carcinomas, 1 invasive mucinous carcinoma, 47 DCIS, 2 lobular carcinomas in situ, and 8 specimens without cancer. Representative images of the main components of the normal breast and the main types of ICs and DCIS were annotated to establish an UFCM atlas. UFCM enables the imaging of the fresh breast tissue sections. Main morphological criteria defined in traditional histopathology such as tissue architecture and cell features can be applied to describe UFCM images content. The generated atlas of the main normal or tumoral tissue features will support the adoption of this optical technology for the intraoperative examination of breast specimens in clinical practice as it can be used to train physicians on UFCM images and develop artificial intelligence algorithms. Further studies are needed to document rare breast lesions.

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Imaging of lumpectomy surface with large field-of-view confocal laser scanning microscopy ‘Histolog® scanner’ for breast margin assessment in comparison with conventional specimen radiography

Cited by 6 publications

References 23 publications

SENOSI Confocal Microscopy: A New and Innovating Way to Detect Positive Margins in Non-Palpable Breast Cancer?

SENOSI Confocal Microscopy: A New and Innovating Way to Detect Positive Margins in Non-Palpable Breast Cancer?

Technologies and techniques to improve precision in breast conserving surgery

Breast tissue imaging atlas using ultra-fast confocal microscopy to identify cancer lesions

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