PhD ceremony Mr. R.G. Pleijhuis: Relevance, targets, and clinical translation of near-infrared fluorescence imaging in breast cancer

PhD ceremony: Mr. R.G. Pleijhuis

Dissertation: Relevance, targets, and clinical translation of near-infrared fluorescence imaging in breast cancer

Promotor(s): prof. G.M. van Dam, prof. T. Wiggers

Faculty: Medical Sciences

Breast cancer is the most common form of malignancy in women. Ultimately, approximately 1 in 8 women will develop breast cancer during her lifetime. In the case of relatively small tumors, patients are generally treated with breast-conserving surgery followed by radiotherapy of the breast. During the surgical procedure, the surgeon removes the primary tumor together with a small rim of normal breast tissue. However, in a substantial amount of patients tumor cells are present at the cutting edge of the excised tissue fragment. These so-called positive surgical margins are considered an important risk factor for local recurrence of the disease. Although the removal of larger tissue fragments would reduce the frequency of positive surgical margins, this would also impair cosmetic results of breast-conserving surgery. Innovative techniques are therefore needed that support the surgeon in differentiating between cancerous tissue and normal breast tissue during the surgical procedure. In the current thesis, a novel technology is described, denominated as near-infrared fluorescence (NIRF) imaging. Tumor cells are hereto labeled with a fluorescent dye, which makes the tumor emit light during surgery. Because the emitted light cannot be detected with the naked eye, a dedicated camera system is applied to visualize the tumor intraoperatively. NIRF imaging is expected to improve the therapeutic outcome of breast-conserving surgery in the future. In addition, research is currently being performed to evaluate whether NIRF imaging can be applied to identify lymph node metastases in an intraoperative setting.