Breast Digital Infrared Analysis (DIRA) , a forgotten and set aside procedure.

Visita: termografiamamaria.blogspot.com (Version en Español)

Breast DIRA (previously named Thermography) already proved in the past that it´s use as an screening procedure had low specificity and high sensitive values for it to be recommended as an standard care Breast diagnosis tool .
Yet , until recently (last 5 years) active research mainly by Surgical Oncologists or Breast Surgeons have published interesting results.( Cornell NY , Addenbrooke Cambridge , Ville Marie Montreal , Taiwan and Mexico CEPREC)
FDA previous published criteria were prohibiting DIRA as well as the A.C. of Radiologists ( as an initial SCREENING TOOL)

Yet it has been cleared by the FDA approval as an adjunctive screening tool for breast cancer .( under 510 k) .

DIRA´s meaning is not an ANATOMIC or ARCHITECTURAL procedure ,it is a METABOLIC or PHYSIOLOGIC ONE so at first it ´s current recommendation should be only as a COMPLEMENTARY STUDY.

As such DIRA could help in specific scenarios, BIRADS 0,3,4 and give potential useful additional data in BIRADS5. EVEN BEFORE BIOPSY
Could aid mammogram in young,dense and breast prosthesis patients, and should be evaluated in other clinical scenarios as a Neoadyuvant Monitoring tool.
Finally as an early detecion procedure specifically in underdeveloped countries , could Triage in search of aggresive forms of the disease(T1,G2_G3). And aid Physical Exam of the Breast .
This site is dedicated to open mind Breast specialists ONLY .
¨EXPANDING OUR CURRENT COMPREHENSION, UNDERSTANDING AND APPROACH OF IMAGE AND DIAGNOSIS IN BREAST CANCER¨

jueves, 20 de junio de 2013

Nanoparticles-Infrared Image-Excised MArgins in Breast Cancer.

Hi everybody , one of the most important problems that we as surgeons have in breast conserving surgery is being able to deliver : SAFE MARGINS.

This is generally achieved as a "BLIND" procedure and it is dependent of individual  clinical and surgical  expertise  in order to produce negative tissue inked margins in the final pathological report , some recommend at least 1 cm of safe distance... so 

QUESTION : Can we in the near Future have an available method that can help us assure this "safety" in margins ?

Recent efforts are being described that couple:


  1.  Nanoparticles associated with 
  2. CANCER SPECIFIC Antibodies 
  3. Nanoparticle excited physical properties  and  
  4. It corresponding image :
Here is an example and is reference ......

I believe : 

"In the near future we will have the Technology by the association of Nanoparticles , monoclonal antibodies and the digital infrared image or another physical and visual intrinsic characteristic , which : 

WILL OFFER in vivo A VISUAL AID FOR THE SURGEON to produce safe margins in breast  conserving surgery ."EMC

Have a great day : 



(A) Schematic representation of nanoparticle communication to achieve amplified tumor targeting. Tumor-targeted signaling nanoparticles (blue) broadcast the tumor location to the receiving nanoparticles (red) present in circulation. (B) Shown are the harnessing of the biological cascade to transmit and amplify nanoparticle communication and the molecular signaling pathway between the signaling and receiving components. (C) Thermographic images of the photothermal NRs with heating. Seventy-two hours after NR or saline injection, mice were co-injected with FXIII-NWs and untargeted control-NWs, and their right flanks were broadly irradiated (top). Twenty-four hours post-irradiation, whole-animal fluorescence imaging revealed the distribution of the receiving nanoparticles (bottom). (D) Amplified tumor therapy with communicating nanoparticles. Tumor volumes following a single treatment with the communicating nanoparticle systems and controls. Reproduced with permission from ref :

 von Maltzahn G, Park JH, Lin KY, Singh N, Schwöppe C, Mesters R. et alNanoparticles that communicate in vivo to amplify tumour targetingNat Mater. 2011;10:545-52



This is another example with Fluorescent propierties...... 

Assessing Breast Cancer Margins Ex Vivo Using Aqueous Quantum-Dot-Molecular Probes
International Journal of Surgical Oncology
Volume 2012 (2012), Article ID 861257, 12 pages
doi:10.1155/2012/861257

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