Publications

@article{Barkur2024-hv,

title = {Intraoperative spectroscopic evaluation of sentinel lymph nodes  in breast cancer surgery},

author = {Surekha Barkur and Radu A Boitor and Raluca Mihai and Navarasi S Raja Gopal and Samuel Leeney and Alexey A Koloydenko and Hazem Khout and Emad Rakha and Ioan Notingher},

doi = {10.1007/s10549-024-07349-z},

year  = {2024},

date = {2024-08-01},

urldate = {2024-08-01},

journal = {Breast Cancer Res. Treat.},

volume = {207},

number = {1},

pages = {223\textendash232},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND AND OBJECTIVES: Sentinel lymph node (SLN) biopsy is a 

 standard procedure for patients with breast cancer and normal 

 axilla on imaging. Positive SLNs on histological examination can 

 lead to a subsequent surgery for axillary lymph node clearance 

 (ALNC). Here we report a non-destructive technique based on 

 autofluorescence (AF) imaging and Raman spectroscopy for 

 intra-operative assessment of SLNs excised in breast cancer 

 surgery. METHODS: A microscope integrating AF imaging and Raman 

 spectroscopy modules was built to allow scanning of lymph node 

 biopsy samples. During AF-Raman measurements, AF imaging 

 determined optimal sampling locations for Raman spectroscopy 

 measurements. After optimisation of the AF image analysis and 

 training of classification models based on data from 85 samples, 

 the AF-Raman technique was tested on an independent set of 81 

 lymph nodes comprising 58 fixed and 23 fresh specimens. The 

 sensitivity and specificity of AF-Raman were calculated using 

 post-operative histology as a standard of reference. RESULTS: 

 The independent test set contained 66 negative lymph nodes and 

 15 positive lymph nodes according to the reference standard, 

 collected from 78 patients. For this set of specimens, the area 

 under the receiver operating characteristic (ROC) curve for the 

 AF-Raman technique was 0.93 [0.83-0.98]. AF-Raman was then 

 operated in a regime that maximised detection specificity, 

 producing a 94% detection accuracy: 80% sensitivity and 97% 

 specificity. The main confounders for SLN metastasis were areas 

 rich in histiocytes clusters, for which only few Raman spectra 

 had been included in the training dataset. DISCUSSION: This 

 preliminary study indicates that with further development and 

 extension of the training dataset by inclusion of additional 

 Raman spectra of histiocytes clusters and capsule, the AF-Raman 

 may become a promising technique for intra-operative assessment 

 of SLNs. Intra-operative detection of positive biopsies could 

 avoid second surgery for axillary clearance.},

keywords = {Auto-fluorescence imaging, Breast cancer, Lymph node metastasis, Raman spectroscopy, Spectral imaging},

pubstate = {published},

tppubtype = {article}

}

@article{Barkur2022-pr,

title = {Intra-operative assessment of sentinel lymph nodes for breast 

 cancer surgery: An update},

author = {Surekha Barkur and Ioan Notingher and Emad Rakha},

year  = {2022},

date = {2022-03-01},

journal = {Surg. Oncol.},

volume = {40},

number = {101678},

pages = {101678},

publisher = {Elsevier BV},

abstract = {Lymph node (LN) involvement is the strongest prognostic factor 

 in operable breast cancer (BC). Therefore, accurate assessment 

 of LN status is essential for management of BC patients. The 

 introduction of sentinel LN approach reduced the need for 

 extensive axillary surgery to achieve accurate staging. However, 

 positive sentinel LN as determined on postoperative histological 

 examination often leads to a second axillary operation to ensure 

 an accurate staging and that positive non-sentinel LNs are 

 removed. Although preoperative assessment of LN has improved 

 significantly, its accuracy remains insufficient to avoid 

 further axillary surgery and is not sufficient to predict the 

 status of the LN. Therefore, intraoperative evaluation of the 

 sentinel LN to determine the need for completing lymph node 

 dissection in case of metastasis can provide an important 

 approach to guide BC management decision making. This article 

 reviews the techniques available and under development for 

 intraoperative detection of sentinel LN metastasis in BC 

 surgery. The key features of each technique are described in 

 detail, emphasising the benefits offered by label-free optical 

 techniques: minimal sample preparation, high spatial resolution, 

 and immediate on-site implementation. Optical techniques have 

 the potential to provide a cost-effective and accurate 

 intraoperative platform for the assessment of SLN within the 

 operating theatre.},

keywords = {Breast cancer, Intra-operative assessment, Lymph nodes, Raman   spectroscopy},

pubstate = {published},

tppubtype = {article}

}

@article{Rweyemamu2021-ik,

title = {The distribution of reproductive risk factors disclosed the 

 heterogeneity of receptor-defined breast cancer subtypes among 

 Tanzanian women},

author = {Linus P Rweyemamu and Gokce Akan and Ismael C Adolf and Erick P Magorosa and Innocent J Mosha and Nazima Dharsee and Lucy A Namkinga and Sylvester L Lyantagaye and Abdolrahman S Nateri and Fatmahan Atalar},

year  = {2021},

date = {2021-12-01},

journal = {BMC Womens. Health},

volume = {21},

number = {1},

pages = {423},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Recent epidemiological studies suggest that 

 reproductive factors are associated with breast cancer (BC) 

 molecular subtypes. However, these associations have not been 

 thoroughly studied in the African populations. The present study 

 aimed to investigate the prevalence of BC molecular subtypes and 

 assess their association with reproductive factors in Tanzanian 

 BC patients. METHODS: This hospital-based case-only 

 cross-sectional study consisted of 263 histologically confirmed 

 BC patients in Tanzania. Clinico-pathological data, 

 socio-demographic characteristics, anthropometric measurements, 

 and reproductive risk factors were examined using the Chi-square 

 test and one-way ANOVA. The association among reproductive 

 factors and BC molecular subtypes was analyzed using multinomial 

 logistic regression. The heterogeneity of the associations was 

 assessed using the Wald test. RESULTS: We found evident subtype 

 heterogeneity for reproductive factors. We observed that 

 post-menopausal status was more prevalent in luminal-A subtype, 

 while compared to luminal-A subtype, luminal-B and HER-2 

 enriched subtypes were less likely to be found in post-menopausal women (OR: 0.21, 95%CI 0.10-0.4},

keywords = {Breast cancer, Heterogeneity, Molecular subtype, Reproductive   risk factors, Tanzania},

pubstate = {published},

tppubtype = {article}

}