The U of A has been leading research into breast cancer with several papers recently published or soon to be published.
The research team of Dr. Lashan Peiris, Oncoplastic and Reconstructive Breast and General Surgeon are working on the following papers:
"Flat Epithelial Atypia: Are we being too aggressive?"
Journal: Breast Cancer Research and Treatment
Status: Submitted not yet accepted
Resident: Dr. Ashley DiPasquale
"Predictors of axillary node response in clinically node-positive patients undergoing neoadjuvant chemotherapy for breast cancer."
Journal: The Breast.
Status: Not yet submitted.
Resident: Dr. Farah Ladak
Although these two studies involve two completely different aspects of breast
surgery, they have an important common theme - they both reflect our ever-
evolving understanding of benign and malignant disease of the breast. Dr. Peiris says, "We are now being more surgically conservative with select benign lesions of the breast, and we are also carefully selecting patients who have undergone pre-operative chemotherapy for less invasive surgery within the axilla."
Dr. John Mackey is an oncologist and member of research teams that published two key breast cancer papers in September.
The British Medical Journal published the work of Dr. Mackey and U of A nutritional scientists, which discovered a fatty acid + chemotherapy combination that shrinks tumours before they are operated on. Clinical trials are now underway. It is a supplement and available over the counter, so it would not require FDA or Health Canada approval. "We should have preliminary results in 18 months," Dr. Mackey says.
Nature Scientific Report published a paper by a team of U of A electrical engineers and Dr. Mackey, which has invented a cancer-detecting laser microscope. "It takes amazing real-time pictures of tissue," Dr. Mackey says. The researchers are now working with Dr. Mackey to develop a tool for the OR, to show any breast cancer that's been missed by the surgeon. This replaces the current way to test tissue margins for cancer, where results come back 10 days later and would result in the patient going back for a second or third operation, with possible resulting complications.
Clinical trials on resected tissue are already underway, with trials on living human tissue planned for late 2020
In October, Health Canada approved an immune therapy, replacing the need for chemotherapy in a type of breast cancer. Dr. Mackey led the clinical trials at the Cross Cancer Institute.
To commercialize U of A-patented cancer therapies Dr. Mackey founded Prephaseone.com, which aims to produce the first-ever successful cancer drug to come out of Alberta. It has 11 projects ongoing, and the first three cancer treatments are entering the regulatory approval stage and approaching clinical trials in a year.
3D Digital Breast Hologram to Aid Surgery
Further into the future, the Department of Surgery aims to combine laser projections and computer algorithm to develop a breast image for projection onto the surgical site as a hologram. This would guide the plastic rebuilding procedure, while linked to motion sensors to provide perfect, real-time mapping.
Surgical Simulation Research Laboratory (SSRL) Director Dr. Bin Zheng says, "We are entering a time when more and more digital images are being introduced to the operating room to enhance surgical outcomes." We are developing a technology to capture a 3D image for a breast, and superimpose a digital model on top of the surgical site to guide a breast reconstruction procedure, he says. In the SSRL, Dr. Yang Li, a physicist and visiting professor from China, projected a thread of structured lights onto a simulated human breast. Through a computer algorithm, he could create a 3D model of the breast with accuracy. Then, the 3D breast model from pre-surgical scanning was projected onto a surgical site where the breast needs to be reconstructed. "Once the technology is mature, we will be able to capture a 3D digital image of a breast from a patient suffering from breast cancer. When she needs rebuild the breast later during plastic surgery, we can display this 3D model onto the surgical site to guide the operation," Dr. Zheng says. Furthermore, in the simulated environment, motion sensors were placed on the chest of the patient to capture her movements during the procedure, which were used to adjust the orientation of the 3D model to ensure a perfect mapping of the surgical site.