Targeting Breast Cancer: Advances in Multimodal Imaging and Oncoplastic Breast Surgery

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Methods and Technologies Development".

Deadline for manuscript submissions: closed (1 October 2023) | Viewed by 2318

Special Issue Editor

West-German Cancer Center, Women's Department, University Hospital of Essen, 45147 Essen, Germany
Interests: breast cancer; breast surgery; breast reconstruction; onco-plastic surgery; minimal invasive breast surgery; magnetic resonance imaging; mammography; tomosynthesis; breast ultrasound; three-dimensional imaging; targeted breast surgery; intraoperative ultrasound; hybrid imaging
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Special Issue Information

Dear Colleagues,

Breast cancer is still the major cause of mortality of women in Europe and Western countries. However, according to recent data, the rates of mortality are declining, with the falls being largest in the age group covered by mammography screening and also in the age group from 20 to 49 years. Advances in imaging performed with multimodal techniques are essential for earlier diagnosis and treatment and, thus, improvement of survival rates with primary breast cancer. To preserve the shape and function of the breast, surgery has developed towards minimally invasive procedures with oncoplastic techniques. It is vital for optimal results that the extent of the tumor is visualized precisely before, during, and after surgery with appropriate imaging techniques, enhancing the rate of margin-free specimens and reducing the need for re-operations. Thus, breast cancer surgery guided by multimodal imaging may be as targeted as systemic therapy targets different tumor profiles.

Especially after exposure of the tumor to cytotoxic drugs with neoadjuvant chemotherapy, it is a challenge to measure the exact size of residual tumor burden and to determine the resection lines.

Complementary diagnostic tools are now evolving, including mammography, tomosynthesis, high-resolution B-mode breast ultrasound, three-dimensional breast ultrasound, strain elastography, shear elastography, automated breast volume scan (ABVS), contrast-enhanced ultrasound (CEUS), MRI, PET-MRI, and MRI-navigated ultrasound.

This issue on “Advances in Multimodal Imaging and Oncoplastic Breast Surgery” encourages scientists to publish their groundbreaking work on advances in imaging and surgical treatment of the main cancer entity of women.

Dr. Peter Kern
Guest Editor

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Keywords

  • breast cancer
  • targeted breast surgery
  • breast ultrasound
  • ultrasound-guided breast surgery
  • multimodal imaging
  • magnetic resonance imaging
  • MRI-navigated ultra-sound
  • mammography
  • tomosynthesis
  • three-dimensional imaging
  • ultra-staging
  • contrast-enhanced ultrasound
  • automated breast volume scan
  • shear wave elastography
  • strain elastography
  • hybrid imaging

Published Papers (1 paper)

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Research

23 pages, 7585 KiB  
Article
Intraoperative Assessment of Breast Cancer Tissues after Breast-Conserving Surgery Based on Mapping the Attenuation Coefficients in 3D Cross-Polarization Optical Coherence Tomography
by Ekaterina Gubarkova, Elena Kiseleva, Alexander Moiseev, Dmitry Vorontsov, Sergey Kuznetsov, Anton Plekhanov, Maria Karabut, Marina Sirotkina, Grigory Gelikonov, Sergey Gamayunov, Alexey Vorontsov, Petr Krivorotko and Natalia Gladkova
Cancers 2023, 15(9), 2663; https://doi.org/10.3390/cancers15092663 - 8 May 2023
Cited by 2 | Viewed by 1999
Abstract
Intraoperative differentiation of tumorous from non-tumorous tissue can help in the assessment of resection margins in breast cancer and its response to therapy and, potentially, reduce the incidence of tumor recurrence. In this study, the calculation of the attenuation coefficient and its color-coded [...] Read more.
Intraoperative differentiation of tumorous from non-tumorous tissue can help in the assessment of resection margins in breast cancer and its response to therapy and, potentially, reduce the incidence of tumor recurrence. In this study, the calculation of the attenuation coefficient and its color-coded 2D distribution was performed for different breast cancer subtypes using spectral-domain CP OCT. A total of 68 freshly excised human breast specimens containing tumorous and surrounding non-tumorous tissues after BCS was studied. Immediately after obtaining structural 3D CP OCT images, en face color-coded attenuation coefficient maps were built in co-(Att(co)) and cross-(Att(cross)) polarization channels using a depth-resolved approach to calculating the values in each A-scan. We determined spatially localized signal attenuation in both channels and reported ranges of attenuation coefficients to five selected breast tissue regions (adipose tissue, non-tumorous fibrous connective tissue, hyalinized tumor stroma, low-density tumor cells in the fibrotic tumor stroma and high-density clusters of tumor cells). The Att(cross) coefficient exhibited a stronger gain contrast of studied tissues compared to the Att(co) coefficient (i.e., conventional attenuation coefficient) and, therefore, allowed improved differentiation of all breast tissue types. It has been shown that color-coded attenuation coefficient maps may be used to detect inter- and intra-tumor heterogeneity of various breast cancer subtypes as well as to assess the effectiveness of therapy. For the first time, the optimal threshold values of the attenuation coefficients to differentiate tumorous from non-tumorous breast tissues were determined. Diagnostic testing values for Att(cross) coefficient were higher for differentiation of tumor cell areas and tumor stroma from non-tumorous fibrous connective tissue: diagnostic accuracy was 91–99%, sensitivity—96–98%, and specificity—87–99%. Att(co) coefficient is more suitable for the differentiation of tumor cell areas from adipose tissue: diagnostic accuracy was 83%, sensitivity—84%, and specificity—84%. Therefore, the present study provides a new diagnostic approach to the differentiation of breast cancer tissue types based on the assessment of the attenuation coefficient from real-time CP OCT data and has the potential to be used for further rapid and accurate intraoperative assessment of the resection margins during BCS. Full article
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