When a patient detects a lump in the breast or a screening mammogram detects a density, a core needle biopsy is performed and the resultant cylinder of tissue is traditionally sectioned, mounted on a slide, H+E stained, and viewed by a pathologist to determine if a patient has cancer versus something more benign. If cancer is diagnosed, the clinicians must then decide if the breast cancer patient receives neoadjuvant chemotherapy followed by surgery or immediately goes into surgery. Some patients benefit from this neoadjuvant chemotherapy (receiving a PCS score of 0 or 1) while some patients do not (receiving a PCS score of 2 or 3). Unfortunately, there is no reliable way of distinguishing these two groups of patients currently.
This invention consists of a system using a multiphoton laser-scanning microscope to quantify the scattering directionality of second harmonic generation (SHG) from needle biopsy samples of breast cancer (and possibly other cancers) in order to predict efficacy of neoadjuvant chemotherapy. The method would take the H+E slides already produced in the clinical workflow, have them mailed to a central laboratory, and then the SHG directionality, specifically the ratio of forward-to-backwards scattered SHG (F/B) would be assessed from key areas of the needle biopsy section. Current data suggests that the tumor/host stroma interface would be imaged, but not the bulk of the tumor. Based upon SHG F/B and perhaps some other clinical variables already in use, a score would be produced that estimates the likely efficacy of neoadjuvant chemotherapy and this score would be returned to the clinician.
- Determine the likely efficacy of neoadjuvant chemotherapy before treatment
- More efficiently and effectively prioritize patients that would benefit from neoadjuvant chemotherapy
- Improve outcomes for patients by not subjecting them to neoadjuvant chemotherapy if they don’t stand to benefit
- Breast cancer
- Possibly other cancers too
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