Abstract
Positive margins have been a critical issue that hinders the success of breast- conserving surgery. The incidence of positive margins is estimated to range from 20% to as high as 60%. Currently, there is no effective intraoperative method for margin assessment. It would be desirable if there is a rapid and reliable breast cancer margin assessment tool in the operating room so that further surgery can be continued if necessary to reduce re-excision rate. In this study, we seek to develop a sensitive and specific molecular probe to help surgeons assess if the surgical margin is clean. The molecular probe consists of the unique aqueous quantum dots developed in our laboratory conjugated with antibodies specific to breast cancer markers such as Tn-antigen. Excised tumors from tumor-bearing nude mice were used to demonstrate the method. AQD-Tn mAb probe proved to be sensitive and specific to identify cancer area quantitatively without being affected by the heterogeneity of the tissue. The integrity of the surgical specimen was not affected by the AQD treatment. Furthermore, AQD-Tn mAb method could determine margin status within 30 minutes of tumor excision, indicating its potential as an accurate intraoperative margin assessment method.
Highlights
Breast cancer is one of the most common cancers among women in the United States and in Western countries
These results indicate that Quantum dots (QDs)-monoclonal Tn antigen antibody (mAb) complexes selectively bind to the Tn antigen protein
We have demonstrated the use of a molecular probe AQD-Tn mAb to assess the surface of excised human cancers grown in nude mice
Summary
Breast cancer is one of the most common cancers among women in the United States and in Western countries. An estimated 226,870 cases of invasive breast cancer and 63,300 ductal carcinomas in situ (DCIS) will be diagnosed among women in the United States in 2012 [1]. Breast cancer is increasingly being diagnosed at an early stage [2] allowing treatment with breast conserving surgery (BCS), in which only the tumor and a small amount of surrounding normal tissue are removed. It was found that for every four local recurrences avoided in patients treated by BCS, one breast-cancer related death was averted [7]. Morbidity and local recurrence rate are higher in patients with positive or close margin (16%) than those with negative margin (6%) [8, 9]. It is best to have the tumor removed cleanly with negative margins on the first surgery [10]
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