Detection of breast cancer precursor lesions by autofluorescence ductoscopy

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 lesio...

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Bibliographic Details
Published in:Breast cancer (Tokyo, Japan) Japan), 2021-01, Vol.28 (1), p.119-129
Main Authors: Waaijer, Laurien, Filipe, Mando D., Simons, Janine, van der Pol, Carmen C., de Boorder, Tjeerd, van Diest, Paul J., Witkamp, Arjen Joost
Format: Article
Language:English
Subjects:
Breast cancer
Cancer
Cancer Research
Comparative analysis
Diagnosis
Endoscopy
Fluorescence
Health aspects
Imaging systems
Medicine
Medicine & Public Health
Oncology
Oncology, Experimental
Original
Original Article
Surgery
Surgical Oncology
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Summary: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 red-to-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.
ISSN:1340-6868
1880-4233
DOI:10.1007/s12282-020-01136-6