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Medical research: Evaluating tumour margins in real-time during breast cancer surgery

19 September 2018

​​​​A method to evaluate the use of fluorescent tracers to determine tumour margins during breast cancer surgery is reported in Nature Communications this week. The results show that the fluorescent tracer, bavacizumab-800CW, is safe and allows for significantly improved detection of tumour margins in patients with breast cancer. 

During tumour removal, surgeons rely on visual inspection and palpation to detect tumour margins, which is an inaccurate methodology. Fluorescent tracers allow labelling of tumour cells and are being tested in clinical trials, but standardized methods to determine the efficacy of a fluorescent tracer are lacking. In addition, existing methods do not readily allow intraoperative monitoring, and require, for example, time-consuming processing of tissue sections, or techniques such as CT scanning and MRI, which cannot be used in real-time during surgery. 

Marjory Koller, principal investigator Gooitzen van Dam and colleagues present the results of a clinical dose escalation trial to evaluate the efficacy of the fluorescent tracer bevacizumab-800CW in 26 patients during breast cancer surgery. The method is designed to fit existing workflows in the operating theatre and to allow the detection of tumour margins in real time. 

The findings show that fluorescent labelling is safe, and resulted in an 88% increase in the intraoperative detection rate of tumour margins. Further studies will be required to determine if this technique decreases the number of positive margins during breast conserving surgery and re-operation rates following surgery.

Read also an interview (in Dutch) with Gooitzen van Dam about his research.​


Gooitzen van Dam (University Medical Center Groningen, Netherlands)
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