Abstract
In the past decades our knowledge of breast cancer has been rapidly evolving yet the basic paradigm of diagnosis and treatment of cancer has not. In cancer diagnosis, presentation of breast cancer can be a palpable lump or a suspicious mass on screening imaging, namely a mammogram. However, malignancy will be ascertained by tissue biopsy if needed. Biopsy is the gold standard breast cancer diagnostic test. Biopsy sampling is invasive, painful and costly. In addition, when the interpretation of current imaging modalities is not concordant with pathology results the biopsies may have to be repeated. Microendoscopy autofluorescence (AM) is a method of acquiring images directly from the tissues that contain fluorescent susceptible molecules (fluorophore). Studies of endoscopy in colon and esophagus showed that AM imaging is capable to recognize malignancy and can be utilized to discriminate between normal tissue and tumor. Additionally, it has been shown that, AM was able to differentiate cancer versus normal cells when a microendoscope was inserted into a breast duct. The main purpose of this study is to investigate if the same contrast exists if AM applied interstitially into the ex-vivo mastectomy breast tissues. This is a feasibility study to explore if interstitial AM has the potential to be coupled with breast cancer imaging diagnostics to provide better discrimination of the characteristics of the target tissue inside. The success in this approach could significantly reduce the number of required tissue biopsies to confirm the diagnosis.
Highlights
Prior to conducting the real experiment on excised female breasts, AF microendoscopy was tested on random samples that to some extent mimics the properties of the human breast toward developing a feasible operational procedure
In order to prevent damage to the delicate probe, the tip of the microendoscope was aligned with the distal end of the Polyshaft and Microendoscope was secured by the optic shifter screw
This experiment was conducted in the same lab prior to pathology assessments and all mastectomy specimens were assessed within 20 minutes following the mastectomy excision
Summary
Breast Cancer is the most common cancer among Canadian women with the exception of non-melanoma skin cancer and is responsible for 15% of all cancer related deaths in women [1]. Once a breast abnormality is found by screening or clinically, depending on the degree of suspicion of cancer, a core biopsy is done to confirm whether the tissue is benign or malignant. Standard white light was previously employed for microendoscopic exploration of breast cancer through ducts along with AF imaging of the tissue of interest recorded at 30 frames/sec. This study integrated the advantages of autofluorescence imaging with interstitial MM to examine its potential to guide breast cancer biopsies. The ultimate aim in this study was to provide the diagnostic radiologist with an additional tool to help differentiate between benign and malignant tissue, and improve the accuracy and reduce the numbers of required biopsies. In this study the same device that has been developed and employed in the ductoscopy study, was coupled to a proper AM
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