Grant: Collaborative Health Research Projects (NSERC partnered)

Breast cancer affects 1 in 8 women during their lives and is the second-leading cause of female cancer related deaths. The ideal treatment is breast-conservation surgery during its early stage to remove the cancer while conserving healthy parts of the breast. Wirth current resection methods, on average, one out of every three women undergoing breast-conservation surgery needs at least one additional surgery due incomplete tumor resection. Repeat surgery leads to increased risk of postoperative complications, impaired cosmetics, delayed radiation therapy, increased psychological distress, and increased costs and risks of undergoing a second general anesthesia. Repeat surgery often leads to full mastectomy, which is a traumatic experience for a patient who expected a curative treatment with breast-conservation. As early stage breast cancer is not palpable or visible, surgeons tend to apply generous "safety margins" around the target tumor and remove a great deal of healthy breast tissue. In current practice, up to 40% of patients who undergo breast-conservation surgery experience severe breast deformity that requires surgical reconstruction, but over half of these women do not get treated due to lack reconstructive surgical capacity. In this research, we aim to develop NaviKnife, a next-generation breast conserving surgery navigation system to achieve complete tumor resection with minimal tissue loss. NaviKnife builds on novel multiparametric ultrasound imaging to accurately target the cancer prior to resection and novel real-time metabolomic tissue typing to identify and trace the tumor boundary during resection while guided by a simple robotic arm. NaviKnife assists the surgeon in precise tumor resection and allows for systematic probing of the resection cavity for residual cancer and, if necessary, guides the surgeon in targeted shaving of the cavity wall with minimal loss of healthy tissue, thus guaranteeing complete tumor removal before the wound is closed.