Optimal resection of breast tumors requires removing cancer with a rim of normal tissue while preserving uninvolved regions of the breast. Surgical and pathological techniques that permit rapid molecular characterization of tissue could facilitate such resections. Mass spectrometry (MS) is increasingly used in the research setting to detect and classify tumors and has the potential to detect cancer at surgical margins. Here, we describe the ex vivo intraoperative clinical application of MS using a liquid micro-junction surface sample probe (LMJ-SSP) to assess breast cancer margins. In a midpoint analysis of a registered clinical trial, surgical specimens from 21 women with treatment naïve invasive breast cancer were prospectively collected and analyzed at the time of surgery with subsequent histopathological determination. Normal and tumor breast specimens from the lumpectomy resected by the surgeon were smeared onto glass slides for rapid analysis. Lipidomic profiles were acquired from these specimens using LMJ-SSP MS in negative ionization mode within the operating suite and post-surgery analysis of the data revealed five candidate ions separating tumor from healthy tissue in this limited dataset. More data is required before considering the ions as candidate markers. Here, we present an application of ambient MS within the operating room to analyze breast cancer tissue and surgical margins. Lessons learned from these initial promising studies are being used to further evaluate the five candidate biomarkers and to further refine and optimize intraoperative MS as a tool for surgical guidance in breast cancer.

乳房肿瘤的最佳切除需要切除带有正常组织边缘的癌症，同时保留乳房未受累的区域。允许对组织进行快速分子表征的外科和病理学技术可以促进这种切除。质谱 (MS) 在研究环境中越来越多地用于检测和分类肿瘤，并有可能在手术边缘检测癌症。在这里，我们描述了使用液体微结表面样品探针 (LMJ-SSP) 评估乳腺癌边缘的 MS 的体外术中临床应用。在一项注册临床试验的中点分析中，前瞻性地收集了 21 名患有初治浸润性乳腺癌的女性的手术标本，并在手术时进行了分析，随后进行了组织病理学测定。来自外科医生切除的乳房肿瘤切除术的正常和肿瘤乳房标本被涂抹在载玻片上以进行快速分析。在操作套件内使用 LMJ-SSP MS 在负电离模式下从这些标本中获取脂质组谱，对数据进行的术后分析揭示了在这个有限的数据集中将肿瘤与健康组织分开的五个候选离子。在考虑将离子作为候选标记之前，需要更多数据。在这里，我们介绍了在手术室内应用环境 MS 来分析乳腺癌组织和手术切缘。从这些初步有希望的研究中吸取的经验教训被用于进一步评估五种候选生物标志物，并进一步完善和优化术中 MS 作为乳腺癌手术指导的工具。