Intra-operative spectroscopic assessment of surgical margins during breast conserving surgery. / Shipp, Dustin W.; Rakha, Emad; Koloydenko, Alexey A.; Macmillan, R.D.; Ellis, Ian; Notingher, Ioan.

In: Breast Cancer Research, Vol. 20, 69, 09.07.2018, p. 1-14.

Research output: Contribution to journalArticle



Background: In over 20% of breast conserving operations, postoperative pathological assessment of the excised tissue reveals positive margins, requiring additional surgery. Current techniques for intra-operative assessment of tumor margins are insufficient in accuracy or resolution to reliably detect small tumors. There is a distinct need for a fast technique to accurately identify tumors smaller than 1 mm2 in large tissue surfaces within 30 min.
Methods: Multi-modal spectral histopathology (MSH), a multimodal imaging technique combining tissue auto-fluorescence and Raman spectroscopy was used to detect microscopic residual tumor at the surface of the excised breast tissue. New algorithms were developed to optimally utilize auto-fluorescence images to guide Raman measurements and achieve the required detection accuracy over large tissue surfaces (up to 4×6.5 cm2). Algorithms were trained on 91 breast tissue samples from 65 patients.
Results: Independent tests on 121 samples from 107 patients - including 51 fresh, whole excision specimens - detected breast carcinoma on the tissue surface with 95% sensitivity and 82% specificity. One surface of each
uncut excision specimen was measured in 12–24 min. The combination of high spatial-resolution autofluorescence with specific diagnosis by Raman spectroscopy allows reliable detection even for invasive carcinoma or ductal carcinoma in situ smaller than 1 mm2.
Conclusions: This study provides evidence that this multimodal approach could provide an objective tool for intra-operative assessment of breast conserving surgery margins, reducing the risk for unnecessary second operations.
Original languageEnglish
Article number69
Pages (from-to)1-14
Number of pages14
JournalBreast Cancer Research
Publication statusPublished - 9 Jul 2018
This open access research output is licenced under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

ID: 28895730