Interactive operation: Mamma Carcinoma

Prof. dr Go M. van Dam MD PhD, surgeon oncologist

Head Optical Molecular Imaging Groningen research group

ISCOMS 2017 offers you the opportunity to experience a surgery together with the other participants. We will show you an operation that has taken place earlier in 2017. During the display of this video, an abdominal oncological surgeon will be on stage to guide us through the operation.

For the first time a surgical team of the UMCG applied an innovative anti-tumor technique in the Netherlands. During the interactive operation session at ISCOMS, video footage of this operation will be displayed and Prof. Go van Dam will guide us through the operation and explain the new fluorescent technique that was used. The use of fluorescent dye makes the tumor luminous so the surgeon can exactly see which tissue must be extracted.

Surgery is one of the main treatments in primary invasive breast cancer. The aim of breast-conserving surgery (BCS) is to remove as little tissue as possible, so tumor-free surgical margins are critical. Only the smallest amount of tissue is removed, so the patient will have a perfect oncological outcome with the best cosmetic result possible.

Molecular imaging with fluorescent dyes is a promising strategy. It can be used to visualize and quantify tumor-specific molecular characteristics. It potentially improves breast cancer care in terms of detection, characterization and (non-)surgical management strategies as well. Expectations are that this will reduce the number of (re)surgery and radiation treatments for breast cancer in the future.

A potential target for molecular imaging in breast cancer is vascular endothelial growth factor (VEGF)-A, involved in tumor angiogenesis. Our study and in particular the video shows that systemic administration of the fluorescent bevacizumab-IRDye800CW tracer is safe for human administration in breast cancer guidance and confirms (tumor-)margin uptake.

As neo-angiogenesis is a universal tumor marker, other more superficially located tumor types like colorectal and esophageal cancer might benefit from fluorescence-guided molecular endoscopy using bevacizumab-IRDye800CW. This approach is of interest for surgical guidance, but also for diagnostic purposes, drug development and treatment monitoring.