Imaging-Based Intraoperative Assessment of Specimen Tumor Margin in Breast Conserving Surgery
Breast cancer remains a leading cause of a morbidity and mortality among women around the world. It is expected that one eighth of women will develop breast cancer, and >2 million new breast cancers are diagnosed each year globally. The advancement of screening and diagnosis tools allows early treatment of breast cancer, which can lead to better survival outcome and quality of life. Breast conserving surgery (BCS) is used as a part of breast cancer treatment in a majority (~70%) of the cases. In BCS, lumpectomy specimen is removed from the breast. It is hoped that tumor is completely enclosed by healthy tissue in the specimen. It is critically important that the specimen is of negative margin in the sense that the tumor is not close to the specimen surface, because a missed positive margin, i.e., the tumor is too close to the specimen surface, will result in a recall of the patient for re-operation to remove the remaining tumor in the breast. Currently, the recall rate is ~20-30%, and there is a strong need to reduce the recall rate. Imaging tools can be developed for intraoperative, accurate assessment of tumor margins in a specimen. We have developed an imaging solution to this clinical problem. The solution includes a mobile, compact imager that can be placed in the operation room for real-time imaging of specimens, and the associated enabling algorithms/software that allow for rapid scanning, image reconstruction, and image analysis and presentation. In the presentation, I will discuss the solution, along with numerous clinical examples illustrating its clinical efficacy for margin assessment and recall-rate reduction in BCS.
Xiaochuan Pan is a Professor in the Department of Radiology, Department of Radiation & Cellular Oncology, the Committee on Medical Physics, the Comprehensive Cancer Center, and the College at The University of Chicago. His research centers on physics, algorithms, and engineering underpinning tomographic imaging and its biomedical and clinical applications. He has developed close clinical and industrial collaboration and established robust translational programs.