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There is no cure for breast cancer.

But a multi-disciplinary group at UWA is perfecting one of the best tools yet for ensuring the closest thing: the most effective surgery for the disease.

Engineers, pathologists, surgeons and radiologists have been working together for more than five years on a microscope-in-aneedle, which can be used during surgery to tell the surgeon where the edge of the cancer is, to improve the rate of success.

Their goal, of breast tumour margin identification during surgery, to prevent women from needing secondary procedures, is in sight.

They are currently using the microscopic probe on tumour tissue and hope to use it on patients within two years.

The collaboration is based at the Optical + Biomedical Engineering Laboratory (OBEL) in the School of Electrical, Electronic and Computer Engineering, led by Winthrop Professor David Sampson, who has been pioneering the use of light in non-invasive medical diagnostic and treatment techniques for many years.

Research Associate Professor Robert McLaughlin last month received the National Breast Cancer Foundation's Innovation and Vision in Research Award, presented by the Governor- General, Quentin Bryce. In 2011, he was awarded a fellowship from the Cancer Council WA of $300,000 over three years.

He, along with Professor Sampson and Winthrop Professor Christobel Saunders (School of Surgery), are spearheading the project.

"When you are pulling together something as complex as this, it's not something you can do by yourself," said Professor McLaughlin, despite being singled out for the prestigious award.

The microscope-in-a-needle can produce an image of the cancer to tell where the edge of the tumour is.

About 34 per cent of patients who have breast-conserving surgery to remove tumours have what are known as ‘insufficient margins'.

"Breast-conserving surgery is where they remove the tumour and surrounding tissue," Professor McLaughlin said. "When a surgeon removes the tumour, a safety margin of healthy tissue is also removed. An insufficient margin does not mean that any cancer is left behind, but it means that there wasn't a large enough safety margin.

"If the margin is small, less than 5mm, there is an increased risk of recurrence, so many of these patients will need to go back for more surgery. About 26 per cent of patients will need more surgery because of insufficient margins.

"The microscope-in-a-needle can guide the surgeon. It is like an ultrasound probe, but it uses light rather than sound so we can see much smaller things. We can see individual fat cells. Cancer cells are a bit smaller, but we can see groups of cancer cells," Professor McLaughlin said.

"We are working on ways to improve our cancer detection. The group is trying a couple of things. One is elastography, which takes a ‘picture' of how something feels. We know that cancers usually feel different - that's why women are encouraged to check their breast for lumps. We've come up with a way to ‘see' that difference with our probes.

"We have recently submitted a patent, through UWA 's Office of Industry and Innovation, for doing elastography with the microscope-in-a-needle technology."

The group already has a patent for its unique combination of using a needle and measuring refractive index. It is licensed to a start-up company, Diagnostic Photonics Inc, in Delaware, USA .

The patent and the group's first paper came together in 2007, a year after they started work. They have had nine papers published and have received $2 million in funding. "

In 2007, with funding for medical devices through the Centre of Excellence in eMedicine, we assembled the engineering team that built the three dimensional optical coherence tomography (OCT )-in-a-needle system," said Professor Sampson, who is also Director of eMedicine at UWA .

"We then developed the capacity to miniaturise the optics and associated scanning systems to fit into hypodermic needles as small as 30-gauge (310 micrometre outer diameter)."

They have published the first 3D OCT images of a human breast tumour taken with a needle probe. The paper will come out next month.

Professor McLaughlin said they had been working with patients after they had tissue removed. "The tissue is taken straight from surgery to the breast centre at QEII and we are using our microscope-in-a-needle to image the cancer cells in that tissue.

"We look forward to doing this with our first patients, during surgery, in about two years. We've still got a lot of work to do first to make sure the probes are safe and effective. These patients are going through one of the scariest days of their life. Our goal is to make it a little less scary," he said.

Professor McLaughlin did his undergraduate degree and PhD in the School, followed by a post-doctoral position at Oxford University, then five years in the medical industry.

"I came back here five years ago specifically to work on breast cancer," he said. "At that stage, only a handful of people in the world had made a needle probe and we worked for two years on making one.

"This project has involved so many skills. We have needed clinical expertise, mathematics, computer hardware skills, and a lot of optics. The reason we have got to where we are today is because we've been fortunate to gather a great bunch of people with such diverse expertise."

Published in UWA News , 16 April 2012