Label-free detection of residual breast cancer after neoadjuvant chemotherapy using biomedical multiphoton microscopy

Lasers Med Sci. 2019 Oct;34(8):1595-1601. doi: 10.1007/s10103-019-02754-z. Epub 2019 Feb 28.

Abstract

Neoadjuvant chemotherapy has become a standard treatment for breast cancer as it has been shown to increase the rate of breast preservation and to improve outcome in patients. However, how to accurately detect residual tumors is still a challenge. In this work, we tried to use multiphoton imaging to look for residual breast tumors after preoperative therapy. Imaging results demonstrate that multiphoton microscopy can identify remaining tumor tissues and can even detect rarely residual tumor cells, which would be helpful for surgeons to accurately assess the surgical margin in real time to confirm negative margins during operation. We also performed a quantification analysis of the nuclear area of tumor cells before and after treatment with neoadjuvant chemotherapy. The measurement data show that the tumor cell nuclei after chemotherapy are significantly larger than those without treatment, and there is a statistically significant difference in the nuclear areas between the pre-treatment and post-treatment mammary carcinoma. Our pilot study indicates the potential utility of multiphoton imaging for detecting residual breast carcinoma tissues in fresh, ex vivo specimens without the use of exogenous contrast agents. We foresee real-time intraoperative applications of multiphoton microscopy in evaluating therapy response, and thereby helping clinicians develop individualized treatment plans.

Keywords: Breast cancer; Multiphoton microscopy; Neoadjuvant chemotherapy.

MeSH terms

  • Adult
  • Aged
  • Breast / pathology
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Cell Nucleus / pathology
  • Female
  • Humans
  • Microscopy, Fluorescence, Multiphoton*
  • Middle Aged
  • Neoadjuvant Therapy*
  • Neoplasm Staging
  • Neoplasm, Residual / diagnosis*
  • Neoplasm, Residual / drug therapy*
  • Staining and Labeling