Lumpectomy, in conjunction with radiation and chemotherapy drugs, together comprise breast-conserving treatment asan alternative to total mastectomy for patients with breast tumors. The tumor is removed in surgery and sent forpathology processing to assess the margins, a process that takes at minimum several hours, and generally days. If themargins are not clear of tumor, the patient must undergo a second surgery to remove residual tumor. This re-excisionrate varies by institution, but can be as high as 60%. Currently, no intraoperative microscopic technique is used routinelyto examine tumor margins in breast tissue. A new technique for rapidly scanning large areas of tissue has beendeveloped, called confocal strip scanning, which provides high resolution and seamless mosaics over large areas ofintact tissue, with nuclear and cellular resolution and optical sectioning of about 2 microns. Up to 3.5 x 3.5 cm2 of tissueis imaged in 13 minutes at current stage speeds. This technique is demonstrated in freshly excised breast tissue, using amobile confocal microscope stationed in our pathology laboratory. Twenty-five lumpectomy and mastectomy cases wereused as a testing ground for reflectance and fluorescence contrast modes, resolution requirements and tissue fixturingconfigurations. It was concluded that fluorescent imaging provides the needed contrast to distinguish ducts and lobulesfrom surrounding stromal tissue. Therefore the system was configured with 488 nm illumination, with acridine orangefluorescent dye for nuclear contrast, with the aim of building an image library of malignant and benign breastpathologies. 

doi: 10.1117/12.2005464; https://doi.org/10.1117/12.2005464