5 Feasibility of WF-OCT as an Adjunct to Intraoperative Specimen X-ray for Breast Conservation Surgical Specimens

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement39th Annual Miami Breast Cancer Conference® - Abstracts
Volume 36
Issue suppl 3
Pages: 25

Background/Significance

Margin status after breast-conserving surgery (BCS) is a critical prognostic factor in breast cancer. Adjunct, intraoperative analysis of excised tumor margins reduces the risk of reexcision surgery by allowing the surgeon to take additional tissue if an involved margin is detected. While intraoperative specimen radiography (SXR) is commonly used as such an adjunct, wide-field optical coherence tomography (WF-OCT) imaging has also demonstrated performance for this purpose. WF-OCT uses near-infrared interferometry to produce high-resolution images of tissue microarchitecture at a depth up to 2 mm and may detect residual malignant tissue not apparent on SXR.


Materials and Methods

This retrospective case series compared SXR with WF-OCT images, collected, and analyzed prospectively. Adult women undergoing BCS for biopsy-proven invasive ductal carcinoma (IDC) or ductal carcinoma in situ (DCIS) at 2 centers were included. Primary excised tumor specimens were imaged intraoperatively with SXR and WFOCT (Perimeter Medical Imaging AI). Additional shaves were taken based on SXR results. WF-OCT images were blinded and reviewed, and not used for clinical decision-making. After closing, all tissue was sent for permanent histopathology, which was designated as ground truth. Histopathology-positive margins in patients without additional cavity shaves were designated as SXR false negatives (SXR-FNs). The WF-OCT results and images from FN patients were compared with the corresponding SXR and final histopathology images.


Results

Eighty-nine consecutive patients undergoing BCS were imaged with SXR and WF-OCT prior to permanent histopathology. Average sensitivity and specificity of SXR were 76.5% and 69.6%, respectively. Six cases, comprising
4 DCIS, 1 IDC, and 1 DCIS with IDC, were designated SXR-FN (additional shaves not taken intraoperatively; positive margin present on final histopathology). In the 5 SXR-FN DCIS cases, suspicious tissue changes were present on WF-OCT; the 1 SXR-FN case not detected by WF-OCT was IDC. Side-by-side comparison of SXR-FN, WFOCT, and ground-truth histology shows the correlating lesion features.


Conclusions

This case series demonstrates that, consistent with ground-truth permanent histology, WF-OCT is able to detect margin positivity in excised tissue that was not apparent on SXR, particularly with respect to DCIS. Although a small case series, these results are encouraging. Additional studies should be tested in a randomized controlled trial.

Author Affiliations:

Savitri Krishnamurthy,1 Payal Salgia,2 David Rempel,2 Andrew Berkeley,2 Beryl Augustine,2 Chandandeep Nagi,3 Alastair Thompson3

1The University of Texas MD Anderson Cancer Center, Houston, TX
2Perimeter Medical Imaging AI, Toronto, Ontario, Canada

3Baylor College of Medicine, Houston, TX

Articles in this issue

15 COVID-19 Disease Course in Immunocompetent and Immunocompromised Patients  in a Breast Cancer Registry
15 COVID-19 Disease Course in Immunocompetent and Immunocompromised Patients in a Breast Cancer Registry
37 The Routine Use of Bioimpedance Spectroscopy Measurements in the Clinic as a Surrogate for Bone Mineral Content in Oncology Patients: Practical Application of the SOZO Device
37 The Routine Use of Bioimpedance Spectroscopy Measurements in the Clinic as a Surrogate for Bone Mineral Content in Oncology Patients: Practical Application of the SOZO Device
18 Psychosocial Wellbeing and Health Care Resource Utilization Among Patients With Breast Cancer During COVID-19
18 Psychosocial Wellbeing and Health Care Resource Utilization Among Patients With Breast Cancer During COVID-19
43 Early Detection of Breast Cancer–Related Lymphedema: Accuracy of Indocyanine Green Lymphography Compared With Bioimpedance Spectroscopy  and Symptoms
43 Early Detection of Breast Cancer–Related Lymphedema: Accuracy of Indocyanine Green Lymphography Compared With Bioimpedance Spectroscopy and Symptoms
3 Frequency of Germline Variants in Breast Cancer Predisposing Genes: Genetic Background of Brazilian Women With Breast Cancer
3 Frequency of Germline Variants in Breast Cancer Predisposing Genes: Genetic Background of Brazilian Women With Breast Cancer
44 Implementation of a Novel Radiopaque Filament Marker at a Single Breast Cancer Surgery Center
44 Implementation of a Novel Radiopaque Filament Marker at a Single Breast Cancer Surgery Center
39TiP The PREDICT Registry: A Prospective Registry Study to Evaluate the Effect of a Predictive Assay on Treatment Decisions in Patients withDCIS Following Breast Conserving Therapy
39TiP The PREDICT Registry: A Prospective Registry Study to Evaluate the Effect of a Predictive Assay on Treatment Decisions in Patients withDCIS Following Breast Conserving Therapy
38 Clinicopathological Risk Factors, Poorly Stratified Baseline Risk, and RT Benefit Compared to DCISionRT in Patients With Ductal Carcinoma in Situ
38 Clinicopathological Risk Factors, Poorly Stratified Baseline Risk, and RT Benefit Compared to DCISionRT in Patients With Ductal Carcinoma in Situ
28 Case Series: Imaging Appearance of Non–Breast Cancer Solid Masses in the Male Breast
28 Case Series: Imaging Appearance of Non–Breast Cancer Solid Masses in the Male Breast
20 Evaluating Number, Age, and Radiographic BIRADS of Patients Visiting Mammography Unit in Baghdad, Iraq, in 2019, 2020, and 2021: A Retrospective Study
20 Evaluating Number, Age, and Radiographic BIRADS of Patients Visiting Mammography Unit in Baghdad, Iraq, in 2019, 2020, and 2021: A Retrospective Study
5 Feasibility of WF-OCT as an Adjunct to Intraoperative Specimen X-ray for Breast Conservation Surgical Specimens
5 Feasibility of WF-OCT as an Adjunct to Intraoperative Specimen X-ray for Breast Conservation Surgical Specimens
41 A Single-Centre Report on the Upgrade Rate of Complex Sclerosing Lesions of the Breast
41 A Single-Centre Report on the Upgrade Rate of Complex Sclerosing Lesions of the Breast
45 The Informed Consent Experience for Breast Cancer Surgery and Its Association With Patient Satisfaction
45 The Informed Consent Experience for Breast Cancer Surgery and Its Association With Patient Satisfaction
29 The Effect of Personality Type on Satisfaction With Information Exchange in Breast Cancer Patients
29 The Effect of Personality Type on Satisfaction With Information Exchange in Breast Cancer Patients
36 Are Positive Margins in DCIS a True Indication of Inadequate Surgery?
36 Are Positive Margins in DCIS a True Indication of Inadequate Surgery?
Related Content