During a lumpectomy for a breast tumor, doctors can’t immediately tell whether all of the cancerous tissue has been removed, with no microscopic signs that cancer cells were left behind. Because of the delay, one in five patients must endure a second surgery to remove remaining cancer. These follow-up operations increase anxiety and healthcare costs, and can lead to delays in receiving other treatments, such as radiation and chemotherapy.

To reduce the need for these second surgeries, four graduate students at Johns Hopkins University, Baltimore, MD, designed a device that can allow pathologists to quickly inspect excised breast tissue within 20 minutes, while the patient is still in the operating room. If the inspection indicates that the tumor was not fully removed, additional tissue can then be removed during the same operation.

While the device is still in the prototype stage, the students say their goal is to give breast cancer patients the same rapid review that commonly occurs when tumors are removed from elsewhere in the body. In those other tumors, pathologists can flash-freeze the tissue and slice samples for microscopic examination. If cancer cells extend to the margin of a sample, the surgeon can quickly remove more tissue. But breast tissue is different because it contains a high fat content and does not freeze well, causing samples to smear and form gaps. Instead, breast tissue must be preserved and analyzed in a more time-consuming process.

Their device applies an adhesive film to the breast tissue before it is sliced, which holds the delicate tissue together and prevents damage to the samples during the slicing process. As a result, the students say that a sample can be reviewed by a pathologist within 20 minutes of its removal, potentially eliminating the need for a second operation on another day.

So far, the team’s system has been tested on animal tissue and human breast samples from a tissue bank, but it has not yet been used on patients.

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