保乳手术的目的是彻底清除所有癌症。目前，术中尚无工具可以对整个肿瘤切除标本进行显微分析，这导致20%～60%的患者进行第二次手术以获得阴性切缘。
2017年5月17日，美国科学促进会《科学》旗下《前沿》在线发表圣路易斯华盛顿大学、约翰·考克伦退伍军人医院、加利福尼亚理工学院的研究报告，发现一种肿瘤标本光声成像扫描技术可在手术过程中快速评定切缘。
该研究将光声效应用于检测并成像，由于不需要进行组织处理或染色，预计标本扫描时长不会超过10分钟，可在手术期间使用。随后，该研究运用新技术对三阴性乳腺癌进行验证，结果显示标本图像清晰，亚细胞核细节都清晰可见。
因此，这些图像有助于区分健康组织和癌变组织，可立即进行再切除，减少手术次数，提高手术成功率。
Sci Adv. 2017 May 17:3(5):e1602168.
Fast label-free multilayered histology-like imaging of human breast cancer by photoacoustic microscopy.
Terence T. W. Wong, Ruiying Zhang, Pengfei Hai, Chi Zhang, Miguel A. Pleitez, Rebecca L. Aft, Deborah V. Novack, Lihong V. Wang.
Washington University in St. Louis, St. Louis, MO, USA; Washington University School of Medicine, St. Louis, MO, USA; John Cochran Veterans Hospital, St. Louis, MO, USA; California Institute of Technology, Pasadena, CA, USA.
The goal of breast-conserving surgery is to completely remove all of the cancer. Currently, no intraoperative tools can microscopically analyze the entire lumpectomy specimen, which results in 20 to 60% of patients undergoing second surgeries to achieve clear margins. To address this critical need, we have laid the foundation for the development of a device that could allow accurate intraoperative margin assessment. We demonstrate that by taking advantage of the intrinsic optical contrast of breast tissue, photoacoustic microscopy (PAM) can achieve multilayered histology-like imaging of the tissue surface. The high correlation of the PAM images to the conventional histologic images allows rapid computations of diagnostic features such as nuclear size and packing density, potentially identifying small clusters of cancer cells. Because PAM does not require tissue processing or staining, it can be performed promptly and intraoperatively, enabling immediate directed re-excision and reducing the number of second surgeries.
DOI: 10.1126/sciadv.1602168
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