Detection of breast cancer precursor lesions by autofluorescence ductoscopy

Abstract

Purpose Autofluorescence is an image enhancement technique used for the detection of cancer precursor lesions in pulmonary and gastrointestinal endoscopy. This study evaluated the feasibility of addition of autofluorescence to ductoscopy for the detection of intraductal breast cancer precursor lesions. Methods An autofluorescence imaging system, producing real-time computed images combining fluorescence intensities, was coupled to a conventional white light ductoscopy system. Prior to surgery, ductoscopy with white light and autofluorescence was evaluated under general anaesthesia in women scheduled for therapeutic or prophylactic mastectomy. Endoscopic findings in both modes were compared, marked and correlated with histology of the surgical specimen. Results Four breast cancer patients and five high-risk women, with a median age of 47 years (range 23-62) were included. In autofluorescence mode, two intraductal lesions were seen in two breast cancer patients, which had an increase in the redto-green fluorescence intensity compared with the surrounding tissue. One lesion had initially been missed by white light ductoscopy but was clearly visible in subsequent autofluorescence mode. One endoscopic finding was classified as suspicious by white light, but was negative in autofluorescence mode and showed normal histology. Conclusions This study demonstrates for the first time the in vivo feasibility of autofluorescence ductoscopy to detect pathologically confirmed breast cancer precursor lesions in both breast cancer patients and high-risk women that were occult under white light.

Metabolic heterogeneity protects metastatic mucosal melanomas cells from ferroptosis

“…Non-invasive diagnostic techniques for identifying malignant tumor cells, monitoring distant metastasis and local recurrence of cancer are improving. In particular, the use of inflammatory markers and autofluorescence to diagnose cancer holds promise (30,72,(74)(75)(76)(77). In addition, red cell distribution width (RdW) value may be applied as a novel inflammatory marker to assess malignant thyroid nodules (74).…”

Robotic nipple-sparing mastectomy complication rate compared to traditional nipple-sparing mastectomy: a systematic review and meta-analysis

“…This technique is already used extensively to help identify pathologies within the airways, larynx, and colon [30][31][32]. Moreover, studies have also shown promising results of (auto) fluorescence for the detection of (pre) cancerous lesions of the breast [33,34]. Consequently, enhanced imaging techniques, such as NBI and (auto) fluorescence, combined with robotic surgery could improve margin determination in patients undergoing breast cancer surgery.…”

Patient-reported outcomes of ductoscopy procedures for pathologic nipple discharge

“…New techniques in ductoscopy are currently being developed and explored to improve the sensitivity for the detection of (pre)malignant lesions. One of these examples is combining ductoscopy with auto-fluorescence imaging [27][28][29]. This addition to ductoscopy may help to detect precancerous lesions in highrisk breast cancer groups since auto-fluorescence has shown to be effective for the detection of precancerous lesions of epithelial origin (such as oesophageal, lung, bronchial and colon cancers) [48][49][50][51][52].…”

“…Previous studies showed the success of ductoscopy in finding the intraductal lesion causing PND before or during duct excision [19][20][21][22][23]. Moreover, it is possible to remove or laser-destruct intraductal lesions causing PND, thereby preventing surgery [18,[24][25][26], and new approaches such as auto-fluorescence ductoscopy may improve the detection of precancerous lesions in patients with high risk of developing cancer [27][28][29]. Despite the increasing relevance of ductoscopy for diagnostic and therapeutic purposes, there are no data available on the impact on the quality of life after ductoscopy.…”