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In vivo Margin Assessment during Partial Mastectomy Breast Surgery Using Raman Spectroscopy[?Q1: Running head: Raman Margin Assessment at Partial Mastectomy. Short title OK?Q1]

¹ George R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts and ² Cleveland Clinic Foundation, ³ University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio

Requests for reprints: Michael S. Feld, George R. Harrison Spectroscopy Laboratory, Massachusetts Institute of Technology, NW-14, 166 Albany Street, Cambridge, MA 02139. Phone: 617-253-7700; Fax: 617-253-4513; E-mail: mxf39{at}case.edu.

We present the first demonstration of in vivo collection of Raman spectra of breast tissue. Raman spectroscopy, which analyzes molecular vibrations, is a promising new technique for the diagnosis of breast cancer. We have collected 31 Raman spectra from nine patients undergoing partial mastectomy procedures to show the feasibility of in vivo Raman spectroscopy for intraoperative margin assessment. The data was fit with an established model, resulting in spectral-based tissue characterization in only 1 second. Application of our previously developed diagnostic algorithm resulted in perfect sensitivity and specificity for distinguishing cancerous from normal and benign tissues in our small data set. Significantly, we have detected a grossly invisible cancer that, upon pathologic review, required the patient to undergo a second surgical procedure. Had Raman spectroscopy been used in a real-time fashion to guide tissue excision during the procedure, the additional reexcision surgery might have been avoided. These preliminary findings suggest that Raman spectroscopy has the potential to lessen the need for reexcision surgeries resulting from positive margins and thereby reduce the recurrence rate of breast cancer following partial mastectomy surgeries. (Cancer Res 2006; 66(6): 3317-22)

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