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The Fine Line between Breast Cancer and Normal Tissues

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Statistics reveal that up to 40% patients who undergo breast cancer surgery have to undergo additional surgeries because surgeons often fail to recognize and remove all the cancerous tissues in the first operation. The good news here is that a recent research at the Brigham and Women's Hospital (BWH) have successfully developed and tested a tool that could aid surgeons significantly in differentiating between cancerous breast tissues from normal tissues. This will reduce the chances of having to perform repeat operations. Breast Cancer

This research was published online in the Proceeding of the National Academy of Sciences on 22nd September 2014.

Breast cancer spreads in stages. There are a number of factors that are taken into consideration for staging breast cancer, like the size of the tumor, whether the cancer has spread to the lymph glands or whether the cancer has metastasized to other parts of the body. There are tests and scans that are carried out to confirm the stage of the cancer and it will give some vital information to the cancer specialist about the best way to treat the cancer. In case breast surgery is recommended then the newly developed tool could be of great help.

This tool is named DESI (Desorption Electro Spray Ionization) mass spectrometry imaging. It works by turning molecules into ions which are the electrically charged versions of themselves. This way the mass of the molecules can be determined. Once the analysis of the mass of the ions is done, the contents of a tissue sample can be identified.


The tool actually sprays a microscopic stream of charged solvent onto the tissue surface. This way it gathers information about its molecular makeup. It then produces a color-coded image which distinctly reveals the nature and concentration of tumor cells.

In order to conduct this study, the researchers used the DESI mass spectrometry imaging and analyzed the amount of fatty acid substances called lipids within breast tissues. A total number of 61 samples were collected from 14 breast cancer patients who had undergone mastectomy. A high tech software program was used to categorize the breast cancer tumors. This way they could differentiate between health tissues and cancerous tissues.

The study revealed that several fatty acids like the oleic acid, etc., were more abundant in the breast in comparison with normal tissues. The results of the study were also confirmed using traditional pathology methods to test for accuracy.

Nathalie Agar, PhD, director of the Surgical Molecular Imaging Laboratory, BWH Departments of Neurosurgery and Radiology, senior study author said that the findings demonstrate that classification of cancerous and normal breast tissues using DESI mass spectrometry imaging is feasible. The results will help to move forward in improving this new method so that surgeons can use it to rapidly detect residual cancer tissues during breast cancer surgery. Since, the cancer cells can be detected all at once through this method, it is will definitely help in decreasing the need for multiple operations. Nathalie Agar, who also is affiliated with the Department of Cancer Biology at Dana-Farber Cancer Institute, also said that researchers plan to continue to work toward validating the identified biomarkers like the fatty acid substances so that tumor margin information can be provided during breast cancer surgery.

Brigham and Women's Hospital also plans to use the tool in the near future to test its performance in its Advanced Multimodality Image Guided Operating (AMIGO) suite. It is hoped that it will definitely help in detecting breast cancer margins during surgery.