Abstract
.Diffuse reflectance spectroscopy (DRS) can discriminate different tissue types based on optical characteristics. Since this technology has the ability to detect tumor tissue, several groups have proposed to use DRS for margin assessment during breast-conserving surgery for breast cancer. Nowadays, an increasing number of patients with breast cancer are being treated by neoadjuvant chemotherapy. Limited research has been published on the influence of neoadjuvant chemotherapy on the optical characteristics of the tissue. Hence, it is unclear whether margin assessment based on DRS is feasible in this specific group of patients. We investigate whether there is an effect of neoadjuvant chemotherapy on optical measurements of breast tissue. To this end, DRS measurements were performed on 92 ex-vivo breast specimens from 92 patients, treated with neoadjuvant chemotherapy and without neoadjuvant chemotherapy. Generalized estimating equation (GEE) models were generated, comparing the measurements of patients with and without neoadjuvant chemotherapy in datasets of different tissue types using a significance level of 5%. As input for the GEE models, either the intensity at a specific wavelength or a fit parameter, derived from the spectrum, was used. In the evaluation of the intensity, no influence of neoadjuvant chemotherapy was found, since none of the wavelengths were significantly different between the measurements with and the measurements without neoadjuvant chemotherapy in any of the datasets. These results were confirmed by the analysis of the fit parameters, which showed a significant difference for the amount of collagen in only one dataset. All other fit parameters were not significant for any of the datasets. These findings may indicate that assessment of the resection margin with DRS is also feasible in the growing population of breast cancer patients who receive neoadjuvant chemotherapy. However, it is possible that we did not detect neoadjuvant chemotherapy effect in the some of the datasets due to the small number of measurements in those datasets.
Highlights
Diffuse reflectance spectroscopy (DRS) is an optical technology that measures the composition and morphology of tissue, based on absorption and scattering of light
We evaluate whether neoadjuvant chemotherapy induces changes in the breast tissue which may affect the use of DRS for margin detection
To investigate if the locations that were measured with the fiber-optic probe were a good representation of the tissue composition of the specimens, the composition of the tissue in the whole hematoxylin and eosin (H&E) sections of the specimens was compared with the composition of the measurement locations
Summary
Diffuse reflectance spectroscopy (DRS) is an optical technology that measures the composition and morphology of tissue, based on absorption and scattering of light. Since our ultimate goal is to use the DRS technology during surgery for the detection of tumor deposits at the resection edge, it is essential to investigate if the changes induced by the neoadjuvant chemotherapy will affect the DRS measurements of the different tissue types. If the DRS measurements are profoundly different, this might affect the optical contrast between tumor tissue and healthy tissue types. This implies that, for the classification of DRS measurements of patients with neoadjuvant chemotherapy, the models based on the measurements of patients without neoadjuvant chemotherapy are not suitable. We evaluate whether neoadjuvant chemotherapy induces changes in the breast tissue which may affect the use of DRS for margin detection
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