Noninvasive in vivo tomographic optical imaging of cellular morphology in the breast: possible convergence of microscopic pathology and macroscopic radiology.

This article presents a pilot study of multispectral diffuse optical tomography for noninvasively imaging volume fraction and mean size of cellular scattering components in the breast. Cellular morphology images for a total of 14 cases (four malignant breast and ten benign lesions) were obtained. Analyzing the images based on the pathological findings of the cases studied, we found that light scattering in the breast was contributed from both the nucleus and organelles such as mitochondria and nucleolus. Based on the image analysis of these 14 cases, we found that the differences in the mean size and volume fraction between the malignant and benign lesions are significant. The contrast ratio of the average mean size and volume fraction between malignant and benign lesions were calculated to be 3.38 and 2.63. These initial results suggest that cellular mean size and volume fraction may be two new criteria that could be used to differentiate malignant from benign lesions.

Intraoperative touch preparation for sentinel lymph node biopsy: a 4-year experience.

BACKGROUND: The optimal technique for intraoperative pathologic examination of sentinel lymph nodes (SLNs) is still controversial. Recent small series report sensitivity between 60% and 100% for various techniques. The aim of this study was to evaluate our long-term experience with touch preparation cytology (TPC) and frozen section (FS) in the intraoperative examination of SLNs for breast cancer. METHODS: A total of 247 patients with operable breast cancer underwent an SLN biopsy for staging of the axilla. The SLN was identified by (99m)Tc-labeled sulfur colloid unfiltered dye, blue dye, or both and dissected, and then intraoperative TPC or FS and permanent section, or both, were performed. RESULTS: A total of 479 SLNs were submitted for TPC and permanent hematoxylin and eosin. A total of 68 SLNs were positive by hematoxylin and eosin; 65 SLNs were positive by TPC, with a false-negative rate of 5.8%. The sensitivity for TPC was 94.2%, with a false-positive rate of 0.2%. A total of 165 SLNs were submitted for FS, with a sensitivity of 85.7% and a specificity of 98.6%. The false-positive rate was 1.4%, with a false-negative rate of 15.8%. CONCLUSIONS: In a large series, TPC is as accurate as FS but is simpler and faster in the detection of intraoperative metastasis in SLNs for breast cancer.