Reducing Unnecessary Surgeries

Breast cancer metastasis may be imaged with laser light system being developed

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) The biggest fear about any cancer is the possibility that it has spread. Figuring this out, though, can involve invasive tests. Scientists are working on a laser light method that could avoid unnecessary surgery.

Laser light that can measure the density and pattern of collagen fibers, may one day be used to see if breast cancer has spread. Researchers at Johns Hopkins are using sophisticated microscopes to analyze the patterns of collagen I fibers (Col1).

The system – when perfected – may be used instead of surgically removing lymph nodes to determine if the cancer has traveled.

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This tiny pilot study involving 14 patients with aggressive breast cancer, led by Kristine Glunde, PhD, demonstrated that shining a laser back and forth over a biopsy tissue sample created “crisscrossing optical images” that illustrated the collagen structure.

The images detailed the thickness and distance between the fibers. Researchers found that women in the study with metastatic disease had denser, more compacted tissue and different patterns than women whose cancer did not spread.

"Our new diagnostic technique has the potential to help reassure thousands of breast cancer patients that their cancers have not spread to other organs, and could help them avoid the risks and pain currently involved in direct inspections of lymph nodes for the presence of cancerous cells," Dr. Glunde said in a press release.

Currently, women who are diagnosed with invasive breast cancer usually undergo surgery that removes surrounding lymph nodes to test them for cancer. This is called a lymph node biopsy.

Complications from this procedure, which can be serious and sometimes permanent, include severe swelling and leakage of lymph fluid into the armpit, as well as pain and infection risk. The surgery can even lead to a permanent stiffening of the arm closest to the cancer.

Experts in cancer imaging have known for more than 10 years that the connective tissue between cancer cells is altered and bunches together as the tumor grows and the cancer spreads, according to co-investigator Zaver Bhujwalla, PhD, a professor at Johns Hopkins and its Kimmel Cancer Center.

Drs. Bhujwalla and Glude, along with investigator Meiyappan Solaiyappan, BS, developed the computer software that can analyze the space between tumor collagen fibers and determine the density of those Col1 fibers.

The authors wrote, “In summary, the results obtained here have identified a potential biomarker that may be useful in the assessment and staging of breast cancer and confirmed the importance of Col1 fibers in the metastatic process.”

Daniel B. Kopans, MD, PhD, told dailyRx News that while he's not an expert in this area, he's concerned about the number of samples that will need to be examined “to be certain that they do not miss the type of collagen associated with tumors that have metastatic spread.”

"Breast cancers are heterogeneous, and, unless the specific kind of collagen is present throughout the biopsied specimen, there could be a very large ‘sampling error,’ said Dr. Kopans, who is professor of radiology at Harvard Medical School and senior radiologist of the Breast Imaging Division at Massachusetts General Hospital.

Larger studies are needed to confirm these findings.

This research, which was funded by the National Cancer Institute, was published November 1 in the Journal of Biomedical Optics. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
November 13, 2012
Last Updated:
November 15, 2012