The use of fluorescence and diffuse reflectance spectroscopy for breast cancer diagnosis

Motivated by the critical need to improve the sampling accuracy of the core needle biopsy, which is being increasingly employed in breast cancer care for early diagnosis of breast malignancy, we proposed a "diagnose-before-sampling" diagram in which an optical sensor based on tissue fluorescence and diffuse reflectance spectroscopy may be used as an adjunct diagnostic tool to guide the biopsy. This work is dedicated to explore the feasibility and efficacy of this technique for the diagnosis of breast cancer.;Ex vivo breast study has been carried out to explore the use of fluorescence and diffuse reflectance spectroscopy over the ultraviolet-visible (UV-VIS) spectrum for the characterization of malignant and non-malignant breast tissues and for the diagnosis of breast cancer. Algorithms based on both empirical spectral analysis and Monte Carlo modeling have been developed to extract the spectroscopic contrasts between normal and diseased breast tissues, which are the "fingerprints" used for breast cancer detection. It was demonstrated that there are statistically significant differences in the fluorescence, absorption and scattering properties between malignant and non-malignant breast tissues, which are also reflected in the different spectral features observed in the tissue spectra. For the sample set investigated in this study, both methods could provide a sensitivity and specificity of up to 89% for discriminating breast malignancy.;The feasibility of using this technique for in vivo diagnosis of breast cancer during clinical breast biopsy was tested through human subject clinical trials. A novel fiber optic probe was developed and employed successfully in the clinical trials for in vivo fluorescence spectroscopy of breast tissues. Results to date showed that malignant tissues could be discriminated from fibrous/benign tissues with a sensitivity and specificity of up to 82% and 87% respectively, and from adipose tissues with a sensitivity and specificity of up to 82% and 81% respectively. Outcome of this preliminary study sets the precedent for the next generation probe design and larger scale clinical trials, which aim to fully test the capability of the spectroscopy technique as an adjunct diagnostic tool to assist the biopsy of malignant breast lesions.