Abstract:
Breast conserving surgery (BCS) offering similar surgical outcomes as mastectomy while retaining breast cosmesis is becoming increasingly popular for the management of early stage breast cancers. However, its association with reoperation rates of 20% to 40% following incomplete tumor removal warrants the need for a fast and accurate intraoperative surgical margin assessment tool that offers cellular, structural and molecular information of the whole specimen surface to a clinically relevant depth. Biophotonic technologies are evolving to qualify as such an intraoperative tool for clinical assessment of breast cancer surgical margins at the microscopic and macroscopic scale. Herein, we review the current research in the application of biophotonic technologies such as photoacoustic imaging, Raman spectroscopy, multimodal multiphoton imaging, diffuse optical imaging and fluorescence imaging using medically approved dyes for breast cancer detection and/or tumor subtype differentiation toward intraoperative assessment of surgical margins in BCS specimens, and possible challenges in their route to clinical translation.
摘要:
保乳手术(BCS)在保留乳房美容的同时提供与乳房切除术相似的手术效果,在早期乳腺癌的治疗中越来越受欢迎。然而,它与肿瘤切除不完全后20%至40%的再手术率相关,保证需要一种快速准确的术中手术切缘评估工具,提供细胞,整个标本表面的结构和分子信息,达到临床相关的深度。生物光子技术正在发展,以符合在微观和宏观尺度上临床评估乳腺癌手术切缘的术中工具的资格。在这里,本文综述了光声成像等生物光子技术的应用研究现状,拉曼光谱,多模态多光子成像,扩散光学成像和荧光成像,使用医学批准的染料进行乳腺癌检测和/或肿瘤亚型分化,以术中评估BCS标本的手术切缘,以及他们在临床翻译过程中可能面临的挑战。