Brigham and Women's Hospital discovered that a new tool can effectively distinguish cancerous breast tissue from normal tissue, according to a study published on Monday in the Proceedings of the National Academy of Sciences.

The tool is called Desorption ElectroSpray Ionization (DESI) mass spectrometry imaging and it works by turning molecules into ions — electrically charged molecules — so that their mass can be determined. When the mass of the ions is determined, then the contents of a tissue sample can be identified.

The tool then sprays a microscopic stream of charged solvent on the surface of the tissue in order to get information about its molecular makeup. Then it generates a color-coded image that shows both the nature and concentration of the cancerous cells.

The researchers at the hospital used 61 samples of breast cancer tissue and normal tissue from 14 breast cancer patients that had a mastectomy, and isolated the margin of the tumor and the regions of normal tissue that were two centimeters and five centimeters away from the tumor.

They performed 2-D imaging with DESI mass spectrometry on all of the tissue sections and correlated it with histopathology to see if there were molecules that could help distinguish the margins of the tumor from the margins of the healthy tissue. They found that it can effectively classify cancerous and normal breast tissue.

Currently there isn't a standard method that allows surgeons to distinguish tissues during surgery. As a result, up to 40 percent of the patients who undergo breast cancer surgery need additional operations because the surgeon did not remove all of the cancerous tissue.

"I started doing this out of compassion for patients but I have since developed a lot of compassion for my colleagues as they have to make extremely important decisions and they don't have the right tools to do that or they could certainly get better tools to do it," Nathalie Agar, senior author of the study and director of the surgical molecular imaging laboratory at the hospital, told DOTmed News.

There are other technologies that are starting to be introduced but Agar believes they aren't as proficient as DESI mass spectrometry. A device that recently received FDA approval is able to look at the surgical margins in the breast but it's based on tissue properties, not molecular information.

Another approach that is being proposed is fluorescent imaging, in which a molecules is injected into the surgical cavity, but it requires labeling. "Typically it will go and label one specific thing so you won't have one of those that fits all types of tumors and organs," said Agar. "Each of those probes will be limited to one or very few applications - you need to have a whole array of those compounds to be able to do that."

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