Abstract
Objective
The present prospective study was conducted to evaluate whether real-time spectral nanoprobe–based optical imaging improved the intraoperative identification of residual malignant tissue during oncoplastic breast surgery when compared with standard intraoperative assessment techniques.
Methods
This prospective clinical study was carried out at a tertiary care hospital in the northern region of Pakistan between January 2022 and June 2024. Female patients diagnosed with early-stage breast carcinoma and scheduled for oncoplastic breast-conserving surgery were enrolled. A targeted spectral nanoprobe system designed to selectively bind malignant breast tissue was utilized intraoperatively. Optical imaging data were acquired in real time following nanoprobe administration and were compared with conventional surgeon-led visual and tactile assessment. Margin status determined by postoperative histopathology served as the reference standard. Sensitivity, specificity, margin positivity rates, and re-excision rates were analyzed.
Results
Spectral nanoprobe imaging demonstrated significantly improved sensitivity for detecting residual malignant tissue compared with standard intraoperative assessment. The rate of positive surgical margins was markedly reduced in the nanoprobe-assisted group. Additionally, a significant reduction in re-excision rates was observed without prolonging operative time or increasing perioperative complications. Optical signal intensity correlated strongly with histopathologically confirmed malignant margins.
Conclusion
Real-time spectral nanoprobe imaging significantly enhanced the detection of residual tumor tissue during oncoplastic breast surgery. The technology showed promise as a safe, effective, and practical adjunct to standard intraoperative assessment, particularly in resource-limited settings. Its adoption may contribute to improved oncological outcomes and reduced reoperation rates in breast-conserving surgery.