An integrated spectroscopy-ultrasound surgical navigation system for residual cancer detection in breast surgery.

乳腺癌影响女性一生中的1/8，是女性癌症相关死亡的第二大原因。理想的治疗方法是早期的保乳手术，在保留健康组织的同时切除癌症。不幸的是，目前的切除方法有高达40%的阳性切缘率(当切除标本的边缘发现癌细胞时)。切缘正值与复发率高相关，因此需要再次手术。平均而言，每三名接受保乳手术的女性中，就有一人需要至少额外做一次手术，因为利润率为正。重复手术会增加术后并发症的风险、美容产品受损、延迟放射治疗、增加心理痛苦、增加二次全身麻醉的费用和风险。重复手术通常会导致乳房全切除，对于希望得到保乳治疗的患者来说，这是一次创伤性的经历。通过开发一种独特的手术导航系统，将术中超声成像与声谱技术相结合，我们打算确保在患者离开手术台之前，切除腔内没有癌症。我们利用传统的超声波扫描仪，同时制造一种独特的频谱超声探头，因此所产生的系统将是负担得起的，加拿大所有的护理机构都可以使用。拟议的系统应能显著降低保证金正值率，从而减少重复手术的次数，并为患者带来显著的生活质量好处，并显著降低医疗保健成本。

Breast cancer affects 1 in 8 women during their lives and is the second-leading cause of female cancer related deaths. The ideal treatment is breast-conservation surgery , during its early stage, to remove cancer while conserving healthy tissue.Unfortunately, the current resection methods have high positive margin rates (when cancer cells are found on the edge of the resected specimen) of up to nearly 40%. Positive margins are linked to high probability of recurrence and thus require repeatsurgery. On average, one out of every three women undergoing breast-conservation surgery needs at least one additional surgery due to positive margins. Repeat surgery leads to increased risk of postoperative complications, impaired cosmetics, delayed radiation therapy, increased psychological distress, and increased costs and risks of asecond general anesthesia. Repeat surgery often leads to full mastectomy, which is a traumatic experience for a patient who expected a curative treatment with breastconservation. Through development of a unique surgical navigation system thatintegrates intra-operative ultrasound imaging with an acoustic spectroscopy technique, we intend to ensure that the resection cavity is clear of cancer before releasing the patient from the operating table. We take advantage of conventional ultrasoundscanners, while building a unique spectroscopic-ultrasound probe, and thus the resulting system will be affordable and accessible to all care facilities in Canada. The proposed system should enable significant reduction in positive margin rates, thereby reducing the number of repeat surgeries, and yielding significant quality of life benefits to patients and a significant reduction in health care costs.