Evidence map›Paper›PMID 29948401›Full record

ArticleBreast cancer research and treatment2018

Real-time, intraoperative detection of residual breast cancer in lumpectomy cavity walls using a novel cathepsin-activated fluorescent imaging system.

Barbara L Smith, Michele A Gadd, Conor R Lanahan, Upahvan Rai, Rong Tang, Travis Rice-Stitt, Andrea L Merrill, David B Strasfeld, Jorge M Ferrer, Elena F Brachtel and 1 more

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Article in Breast cancer research and treatment, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 1 synthesis or guideline pooled it, 84 citations in OpenAlex.

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  9. Advancements in Intraoperative Imaging for Enhanced Surgical Precision.Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Barbara L SmithDivision of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA. blsmith1@mgh.harvard.edu.ORCID http://orcid.org/0000-0003-4281-665X
Michele A GaddDivision of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Conor R LanahanDivision of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Upahvan RaiDivision of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Rong TangDivision of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Travis Rice-StittDepartment of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Andrea L MerrillDivision of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
David B StrasfeldLumicell, Inc, 80 William Street #260, Wellesley, 02481, MA, USA.
Jorge M FerrerLumicell, Inc, 80 William Street #260, Wellesley, 02481, MA, USA.
Elena F BrachtelDepartment of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Michelle C SpechtDivision of Surgical Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Massachusetts General Hospital · USLumicell (United States) · US

Funding

Harvard Clinical and Translational Science CenterUL1TR001102 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$106.2M
Phase II clinical study of real-time tumor bed imaging in breast cancer patientsR21CA173762 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI SMITH, BARBARA LYNN · 2013 to 2014
$512k
National Cancer Institute 1R21CA173762-01National Institutes of Health 1UL1TR001102NCATS NIH HHS UL1 TR001102NCI NIH HHS R21 CA173762
6 · The paper itself

Abstract

purposeObtaining tumor-free surgical margins is critical to prevent recurrence in breast-conserving surgery but it remains challenging. We assessed the LUM Imaging System for real-time, intraoperative detection of residual tumor.

methodsLumpectomy cavity walls and excised specimens of breast cancer lumpectomy patients were assessed with the LUM Imaging System (Lumicell, Inc., Wellesley MA) with and without intravenous LUM015, a cathepsin-activatable fluorescent agent. Fluorescence at potential sites of residual tumor was evaluated with a sterile hand-held probe, displayed on a monitor and correlated with histopathology.

resultsBackground autofluorescence was assessed in excised specimens from 9 patients who did not receive LUM015. In vivo lumpectomy cavities and excised specimens were then imaged in 15 women undergoing breast cancer surgery who received no LUM015, 0.5, or 1 mg/kg LUM015 (5 women per dose). Among these, 11 patients had invasive carcinoma with ductal carcinoma in situ (DCIS) and 4 had only DCIS. Image acquisition took 1 s for each 2.6-cm-diameter surface. No significant background normal breast fluorescence was identified. Elevated fluorescent signal was seen from invasive cancers and DCIS. Mean tumor-to-normal signal ratios were 4.70 ± 1.23 at 0.5 mg/kg and 4.22 ± 0.9 at 1.0 mg/kg (p = 0.54). Tumor was distinguished from normal tissue in pre-and postmenopausal women and readings were not affected by breast density. Some benign tissues produced fluorescent signal with LUM015.

conclusionThe LUM Imaging System allows rapid identification of residual tumor in the lumpectomy cavity of breast cancer patients and may reduce rates of positive margins.

Indexed as

CathepsinsMastectomy, SegmentalOptical ImagingAdultAgedBiopsyBreast NeoplasmsFemaleHumansImmunohistochemistryIntraoperative PeriodMiddle AgedNeoplasm, ResidualSurgery, Computer-AssistedCathepsinsBreast cancerImage-guided surgeryIntraoperative tumor detectionLumpectomy surgery

Identifiers

PMID29948401
PMCPMC6193492
OpenAlexW2806972482

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.