Breast cancer is the most common form of cancer among women, accounting for approximately 24% of all cancer cases. However, nowadays the medical care for breast cancer patients is still far from satisfactory. For instance, the surgical outcomes of breast tumor surgery may leave residual tumor, which often causes cancer relapse. This leads to tedious and painful follow-up treatments, and high mortality rate. In addition, because of fear of having residual tumors, it is hard for surgeons to conserve breasts for young patients who desire better cosmetic outcomes. Also, breast cancer surgery is so complicated that only experienced doctors with expensive equipment can do a good surgery. If initial surgery is not successful, the patient has to return for another round of the painful and tedious procedure, which is a burden on the patient and our healthcare system. To stage breast cancer, it is common to undertake sentinel lymph node (SLN) biopsy. Infection of this node suggests that the cancer has spread beyond the primary tumor region. A positive SLN then leads to the removal of many other nodes called axilliary lymph nodes, for assessment of the presence of tumor. For precautionary reasons, many nodes are removed for this test but they generally come back negative. Many patients develop swelling (lymphedema) that can be both uncomfortable and potentially fatal. To address these problems, we designed a simple device that every doctor can use. Moreover, the device will allow a surgeon to visualize the tumor and tumor margins intraoperatively and in real time. This has many advantages. Complete cancer removal will be assured so patients do not have to worry about potential relapse from residual tumors and painful follow-up treatments. Moreover, using our device, normal tissues will be spared in breast conservation surgery. This will help to improve confidence and life quality of patients, especially the younger ones. Furthermore, our device can also simplify the procedures in SLN biopsy. With the administration of specific imaging agents that selectively light up cancerous tissues with invisible near-infrared light that can be detected by our device, doctors can make instant decision whether the node is positive or negative. This information will guide node removal for further analysis, thereby sparing healthy lymph nodes. Worth mentioning, our device is also integrated with real-time communication capability. Thus, experts in top medical centers can see and supervise breast cancer surgery in remote areas or even other countries with less expertise in real time.
My career goal is to become a professor in a reputable academic institution in the field of breast cancer imaging research. The interdisciplinary training I will receive at Washington University will facilitate developing a solid background for breast cancer research from a revolutionary co-mingling of engineering with the biological, chemical, physical, and quantitative sciences. In addition, I have a team of mentors that will provide me with outstanding mentorship in breast cancer research from basic sciences and clinical perspectives. The proposed research plan will provide me with opportunities for training in a research setting that involves multiple disciplines related to breast cancer research. Such experience will not only augment my expertise in breast cancer research but also will enlighten my vision in multidisciplinary innovative research. This will enable me to integrate my capacity in engineering with my knowledge in other breast cancer-related fields to solve practical problems. In addition, close collaboration with top breast cancer clinicians will further sharpen my perception of breast cancer research from the clinical perspectives. Furthermore, the collaborative nature of proposed research will inspire me to develop excellent management and leadership skills, which will greatly benefit my future career as a breast cancer researcher who leads a multidisciplinary team.
The proposed device can be used in any surgical suite in any medical center to benefit the breast cancer patient who either needs surgery or tumor staging. It will improve surgical efficacy and cosmetic outcomes while reducing side effects associated with these procedures. Its low cost (estimated under $1000 of the whole device) renders it particularly attractive for any medical center around the world, especially rural clinics and medical centers in third world countries. It will take approximately three years to finalize development and evaluation of the prototype device, and it will take additional two to three years to be translated in clinical settings.
This research provides a simple, accurate, and affordable method to solve a complicated problem in breast cancer research, which will likely have multiple impacts on the field, listed as follows. First, it can ensure completeness of tumor removal and minimize cancer recurrence, and thus improve survival rate and life quality. Also, it can indentify positive lymph nodes so that patients do not have to go through painful SLN biopsy. In addition, easy operation of the proposed device may inspire researchers to re-think the design of current intraoperative imaging modalities which are typically complex. The high accuracy and low cost of our device will change the world of breast cancer management in a revolutionary manner. With such a device, now for the first time, every patient everywhere can easily receive high quality breast cancer surgery without worrying about cancer recurrence from missed cancer tissue and tedious follow-up treatments.