Margin assessment during breast conserving surgery using diffuse reflectance spectroscopy

Dinusha Veluponnar*, Lisanne L. de Boer*, Behdad Dashtbozorg*, Lynn-Jade S. Jong, Freija Geldof, Marcos Da Silva Guimaraes, Henricus J.C.M. Sterenborg, Marie-Jeanne T.F.D. Vrancken-Peeters, Frederieke van Duijnhoven, Theo Ruers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Significance: During breast-conserving surgeries, it is essential to evaluate the resection margins (edges of breast specimen) to determine whether the tumor has been removed completely. In current surgical practice, there are no methods available to aid in accurate real-time margin evaluation.

Aim: In this study, we investigated the diagnostic accuracy of diffuse reflectance spectroscopy (DRS) combined with tissue classification models in discriminating tumorous tissue from healthy tissue up to 2 mm in depth on the actual resection margin of in vivo breast tissue.

Approach: We collected an extensive dataset of DRS measurements on ex vivo breast tissue and in vivo breast tissue, which we used to develop different classification models for tissue classification. Next, these models were used in vivo to evaluate the performance of DRS for tissue discrimination during breast conserving surgery. We investigated which training strategy yielded optimum results for the classification model with the highest performance.

Results: We achieved a Matthews correlation coefficient of 0.76, a sensitivity of 96.7% (95% CI 95.6% to 98.2%), a specificity of 90.6% (95% CI 86.3% to 97.9%) and an area under the curve of 0.98 by training the optimum model on a combination of ex vivo and in vivo DRS data.

Conclusions: DRS allows real-time margin assessment with a high sensitivity and specificity during breast-conserving surgeries.

Original languageEnglish
Article number045006
JournalJournal of biomedical optics
Issue number4
Publication statusPublished - 25 Apr 2024


  • Breast-conserving surgery
  • Diffuse reflectance spectroscopy (DRS)
  • Resection margin assessment
  • Tissue classification


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