 |
Scanning electron microscopy image of a breast cancer cell. Credit: Bruce Wetzel & Harry Schaefer, courtesy of the National Cancer Institute. |
Nearly 13 percent of women born in the U.S. today will develop breast cancer at some point during their lives. Treatment for early-stage disease often includes breast-conserving surgery, where the tumor and some surrounding healthy tissues (the tumor margin) are removed. However, around 20 percent of these surgeries require a second operation, generally because cancer cells are found within the tumor margins.
Now, NIBIB-funded researchers are developing an imaging method that would allow surgeons to better identify cancerous cells in the tumor margins during surgery. This technique could lead to a reduction in follow-up breast cancer surgeries and reduce rates of breast cancer recurrence. Results were recently published in eBioMedicine, a publication of The Lancet.
“Today, surgeons primarily rely on their sense of sight and touch to distinguish between healthy and cancerous tissues during surgery, which may lead to incomplete removal of the tumor,” said Tatjana Atanasijevic, Ph.D., manager of the NIBIB program in Molecular Probes and Imaging Agents. “This imaging technique provides real-time visual feedback during surgery, allowing surgeons to better gauge the breast tumor margins, and ultimately optimizing surgical excision.”
The technique relies on a method known as near-infrared imaging, which utilizes probes that fluoresce under near-infrared light. These fluorescent probes can allow clinicians to visualize features beyond the tissue surface, such as blood vessels or tumors, which can help to guide surgical procedures. However, there aren’t many near-infrared agents that are approved for clinical use by the U.S. Food and Drug Administration (FDA), and those that are approved are non-specific, meaning that they don’t home in on a specific target in the body. Further, the only near-infrared probe approved for surgery, indocyanine green (ICG), doesn't stay in the bloodstream for very long and therefore its utility for image-guided tumor resection is somewhat limited.