98 Participants Needed

Nonlinear Microscopy for Surgical Evaluation in Breast Cancer

JC
Overseen ByJames Connolly, MD
Age: 18+
Sex: Female
Trial Phase: Academic
Sponsor: Beth Israel Deaconess Medical Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new imaging tool called a nonlinear microscope (NLM) to assist during breast cancer surgery. The goal is to use the NLM to examine the edges of removed tissue during a lumpectomy, potentially avoiding additional surgeries if cancer is later found at the edges. Participants will undergo surgery either with or without this new imaging. The trial seeks women scheduled for breast cancer surgery who have had a biopsy showing invasive breast cancer or DCIS (a type of non-invasive cancer). As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could enhance surgical outcomes for future patients.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications. However, it does exclude those who have had any systemic neoadjuvant (preoperative) therapy between the core biopsy and lumpectomy.

What prior data suggests that this nonlinear microscopy is safe for surgical evaluation in breast cancer?

Research has shown that a special imaging technique called nonlinear microscopy has been safely used to examine breast and rectal cancer tissues. These studies found it to be very accurate in diagnosing these cancers, with no harmful effects reported. In simpler terms, this imaging method has been used during surgery without causing any negative side effects.12345

Why are researchers excited about this trial?

Researchers are excited about the use of nonlinear microscopy in breast cancer surgery because it offers a new way to evaluate surgical margins in real-time. Unlike standard lumpectomy procedures, which rely on post-surgical pathology to detect any remaining cancerous tissue, nonlinear microscopy provides instant imaging of excised tissue. This technique could potentially allow surgeons to identify and remove residual cancer right away, reducing the need for additional surgeries and improving patient outcomes.

What evidence suggests that nonlinear microscopy is effective for evaluating surgical margins in breast cancer?

Research has shown that nonlinear microscopy (NLM), which participants in this trial may receive, is a promising tool for examining breast tissue during surgery. Studies have found that NLM can quickly create images similar to those seen under a regular microscope, without needing to prepare the tissue first. This allows doctors to check in the operating room if cancer cells are near the edges of the removed tissue. If cancer cells are found, more tissue can be removed immediately, potentially reducing the need for another surgery later. Initial findings suggest NLM could improve the success of lumpectomies (breast-conserving surgeries) by helping ensure all cancer is removed. Meanwhile, the control arm of this trial involves standard lumpectomy without NLM imaging.25678

Who Is on the Research Team?

JC

James Connolly, MD

Principal Investigator

Beth Israel Deaconess Medical Center

Are You a Good Fit for This Trial?

This trial is for women over 21 with breast cancer who are scheduled for lumpectomy at BIDMC. They must have certain hormone receptor statuses confirmed, be eligible for surgery and radiation, and not pregnant. Those with previous surgeries at the cancer site or on neoadjuvant therapy can't join.

Inclusion Criteria

I am at least 21 years old.
Ability to understand and the willingness to sign a written informed consent document
I am scheduled for a lumpectomy at BIDMC for breast cancer.
See 7 more

Exclusion Criteria

I cannot undergo radiation therapy due to health reasons.
I have cancer or DCIS where I've had surgery before.
I received treatment before my breast surgery.
See 7 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Surgery and Imaging

Participants undergo standard lumpectomy with or without nonlinear microscopy imaging of excised surgical margins

1 day
1 visit (in-person)

Postoperative Pathologic Evaluation

Standard pathologic evaluation of the specimen is performed some days after lumpectomy to decide on the need for additional surgery

1-2 weeks

Follow-up

Participants are monitored for recommendations on additional surgery based on postoperative histopathology

2 years

What Are the Treatments Tested in This Trial?

Interventions

  • Nonlinear Microscopy Imaging of Excised Surgical Margins
  • Standard Lumpectomy without Nonlinear Microscopy Imaging
Trial Overview The study compares using a new imaging tool called nonlinear microscope (NLM) during lumpectomy to standard practice without NLM. The goal is to see if NLM can better ensure all cancer is removed during the initial surgery.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: ExperimentalExperimental Treatment1 Intervention
Group II: ControlActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Beth Israel Deaconess Medical Center

Lead Sponsor

Trials
872
Recruited
12,930,000+

Dana-Farber Cancer Institute

Collaborator

Trials
1,128
Recruited
382,000+

Massachusetts Institute of Technology

Collaborator

Trials
104
Recruited
12,810,000+

Published Research Related to This Trial

Multiphoton imaging has shown promise in accurately detecting residual breast tumors after neoadjuvant chemotherapy, which can help surgeons confirm negative surgical margins in real time during operations.
The study found that tumor cell nuclei were significantly larger after chemotherapy compared to before treatment, indicating a measurable change that could assist in evaluating treatment response and tailoring future therapies.
Label-free detection of residual breast cancer after neoadjuvant chemotherapy using biomedical multiphoton microscopy.Han, Z., Li, L., Kang, D., et al.[2020]
Multimodal nonlinear optical microscopy can effectively monitor therapeutic responses in rectal cancer, identifying key histopathological changes such as tumor regression and inflammatory responses without the need for labeling.
This technique shows promise as a real-time, in vivo imaging method that could help clinicians tailor treatment strategies by providing immediate insights into the effectiveness of neoadjuvant therapy.
Monitoring neoadjuvant therapy responses in rectal cancer using multimodal nonlinear optical microscopy.Li, LH., Chen, ZF., Wang, XF., et al.[2019]
Nonlinear microscopy (NLM) demonstrated high diagnostic accuracy in assessing breast excision specimens, achieving 95.4% sensitivity and 93.3% specificity for identifying invasive cancer and ductal carcinoma in situ compared to traditional histology.
NLM allows for rapid imaging of fresh surgical specimens without the need for fixation or embedding, making it a promising method for intraoperative margin assessment, which is crucial for reducing the need for reexcision in breast-conserving cancer surgery.
Assessment of breast pathologies using nonlinear microscopy.Tao, YK., Shen, D., Sheikine, Y., et al.[2022]

Citations

Real-Time Assessment Of Breast Cancer Lumpectomy ...This research is studying a new investigative imaging instrument called a nonlinear microscope (NLM). A nonlinear microscope can produce images similar to an ...
Assessment of breast pathologies using nonlinear ...The results suggest that nonlinear microscopy is a promising method for intraoperative assessment of breast surgical excision specimens. Abstract. Rapid ...
Development of intraoperative assessment of margins in ...We intend to provide an informative and up-to-date summary on the topic of intraoperative assessment of margins in breast conserving surgery (BCS).
4.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/25313045/
Assessment of breast pathologies using nonlinear microscopyWe demonstrate nonlinear microscopy (NLM) for the assessment of benign and malignant breast pathologies in fresh surgical specimens.
Real-Time Assessment Of Breast Cancer Lumpectomy ...A nonlinear microscope can produce images similar to an ordinary pathologist's microscope, but without first processing tissue to make slides.
Real-Time Assessment Of Breast Cancer Lumpectomy ...This research is studying a new investigative imaging instrument called a nonlinear microscope (NLM). A nonlinear microscope can produce images similar to an ...
Nonlinear Microscopy for Surgical Evaluation in Breast ...Nonlinear microscopy has been used safely in studies for assessing breast and rectal cancer tissues, showing high diagnostic accuracy and no adverse effects ...
Assessment of breast pathologies using nonlinear microscopyBlinded reading of nonlinear microscopy images by three pathologists achieved 95.4% sensitivity, 93.3% specificity, and 94.1% overall accuracy ...
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