Our Summary

This study looked at the use of a technique called pegulicianine fluorescence-guided surgery (pFGS) in breast cancer surgeries. The goal was to see if this method could better identify and remove cancerous tissue during surgery, potentially reducing the need for a second surgery. The study involved 406 patients with Stage 0 to 3 breast cancer. The results showed that pFGS was able to identify and remove additional cancerous tissue that was left behind after a standard lumpectomy in 27 patients. This helped to avoid a second surgery in 9 patients whose initial surgery left some cancer behind. However, the method was only moderately effective in accurately identifying cancerous tissue. There were a few side effects experienced by patients, which led to stopping the use of pegulicianine in six cases. The study was funded by Lumicell, Inc. and the National Institutes of Health.

FAQs

  1. What is the goal of using pegulicianine fluorescence-guided surgery (pFGS) in breast cancer surgeries?
  2. How effective was the pFGS technique in identifying and removing additional cancerous tissue after a standard lumpectomy?
  3. What were the side effects experienced by patients using pegulicianine in the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about lumpectomy is to follow all post-operative care instructions carefully, including avoiding heavy lifting or strenuous activity for a certain period of time, caring for the incision site properly, and attending follow-up appointments as scheduled. Additionally, it’s important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for lumpectomy are those with early-stage breast cancer, usually Stage 0 to 2. Lumpectomy is a common surgical option for patients with smaller tumors that have not spread to the surrounding tissue. It is often recommended for patients who want to preserve as much of their breast tissue as possible, while still effectively treating the cancer. Lumpectomy may also be recommended for patients who are not good candidates for mastectomy, either due to medical reasons or personal preference. Additionally, lumpectomy may be recommended for patients who have had a tumor successfully shrunk with neoadjuvant therapy, making it possible to remove the remaining cancerous tissue with surgery.

Timeline

Before lumpectomy:

  • Patient undergoes diagnostic tests such as mammogram, MRI, and biopsy to confirm the presence of breast cancer.
  • Patient meets with their healthcare team to discuss treatment options, including lumpectomy.
  • Patient may undergo preoperative tests and evaluations to ensure they are healthy enough for surgery.
  • Patient may receive instructions on how to prepare for the surgery, including fasting before the procedure.

During lumpectomy:

  • Patient is given anesthesia to ensure they are comfortable and pain-free during the procedure.
  • Surgeon removes the cancerous tissue along with a margin of healthy tissue to ensure all cancer cells are removed.
  • The removed tissue is sent to a pathology lab for analysis to determine if the margins are clear or if additional surgery is needed.

After lumpectomy:

  • Patient may experience pain, swelling, and discomfort at the surgical site.
  • Patient may be prescribed pain medication and antibiotics to prevent infection.
  • Patient may have follow-up appointments with their surgeon to monitor healing and discuss the results of the pathology report.
  • Patient may undergo radiation therapy to destroy any remaining cancer cells in the breast.
  • Patient may undergo hormone therapy or chemotherapy to reduce the risk of cancer recurrence.
  • Patient may be advised to follow a healthy lifestyle, including regular exercise and a balanced diet, to improve overall health and reduce the risk of cancer recurrence.

What to Ask Your Doctor

  1. What is a lumpectomy and why is it being recommended for me?

  2. How will pegulicianine fluorescence-guided surgery (pFGS) be used during my lumpectomy?

  3. What are the potential benefits of using pFGS during my surgery?

  4. What are the potential risks or side effects of using pFGS during my surgery?

  5. How likely is it that pFGS will accurately identify and remove all of the cancerous tissue during my lumpectomy?

  6. If pFGS does not completely remove all of the cancerous tissue, what are my options for further treatment?

  7. How will the results of the pFGS procedure affect my overall treatment plan and prognosis?

  8. Are there any alternative surgical techniques or approaches that I should consider?

  9. What is the success rate of pFGS in reducing the need for a second surgery in patients with breast cancer?

  10. Are there any ongoing clinical trials or research studies investigating the use of pFGS in breast cancer surgeries that I should be aware of?

Reference

Authors: Smith BL, Hunt KK, Carr D, Blumencranz PW, Hwang ES, Gadd MA, Stone K, Dyess DL, Dodge D, Valente S, Dekhne N, Clark P, Lee MC, Samiian L, Lesnikoski BA, Clark L, Smith KP, Chang M, Harris DK, Schlossberg B, Ferrer J, Wapnir IL. Journal: NEJM Evid. 2023 Jul;2(7):EVIDoa2200333. doi: 10.1056/EVIDoa2200333. Epub 2023 Apr 27. PMID: 38320161