Revolution in breast-conserving surgery
The Spectra-BREAST research project, which aims to improve breast-conserving surgery for breast cancer treatment, has officially started. Funded by the European Innovation Council under the Pathfinder Open 2024 programme for a total of €3 million, the four-year project involves a consortium of six top institutions with the goal of developing a tool to provide surgeons with real-time information on the presence of residual tumour cells during resection, thereby reducing the risk of recurrence and the need for repeat operations.
The project is led by IRCCS Maugeri in Pavia in collaboration with NIREOS and the Consiglio Nazionale delle Ricerche – Istituto di Fotonica e Nanotecnologie (CNR-IFN), experts in hyperspectral imaging and spectroscopy. Other participants include the Politecnico di Milano, with its engineering expertise in optics and robotics; RiverD, a company specialising in the use of Raman spectroscopy in medicine; and the Universidad Politécnica de Madrid, which is engaged in developing artificial intelligence models.
One in eight women will develop breast cancer and when possible, breast-conserving surgery is the first choice for treating the disease in its early stages. However, tumour cells remaining on the surgical margins after resection is not uncommon and necessitates a second operation to avert the risk of recurrence, with inconveniences for patients and costs for the National Health System. This is because surgeons removing tumour masses do not have access to tools that allow them to immediately determine whether a sufficient area of tissue has been removed, and they must wait for results from the anatomical pathology lab to determine whether more tissue needs to be removed.
The Spectra-BREAST project combines hyperspectral imaging and Raman spectroscopy to analyse tissue composition, along with robotics and artificial intelligence to provide surgeons with immediate feedback during surgery. The combination of these optical systems will help to distinguish tumour cells from non-tumour cells. The hyperspectral camera makes an initial survey and flags suspicious parts, which are then analysed in more detail using Raman spectroscopy. Artificial intelligence is used to analyse the collected data, providing the surgeon with precise indications on excision margins.
The Politecnico di Milano will be responsible for coupling the two techniques (hyperspectral and Raman spectroscopy) to create a “complete” tool for surgeons, so that they can see the excised tissue on the screen in false colours and identify tumour areas or areas at risk of tumour infiltration. To achieve the objectives of Spectra-BREAST, we will combine different skills — photonics and electronics, robotics and artificial intelligence — to increase the technological development of the device, patenting all the inventions that arise from the scientific research and determining the best implementation of the device for its future testing in the clinic and marketing in the long term.
Dario Polli, Professor at the Department of Physics and head of the unit at the Politecnico di Milano.