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Combining Light and Ultrasound

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How to help surgeons perform breast cancer surgery more successfully

Lawrence Yip - BCSC Breast Cancer Funded ResearcherLawrence Yip, a PhD candidate in the Department of Medical Biophysics at Western University, works at St. Joseph’s Hospital in Dr. Jeffrey Carson’s lab developing a new imaging technology to help surgeons treat breast cancer. In collaboration with his lab colleagues, Lawrence seeks to build a portable system that will be reliable and inexpensive.

Medical Biophysics is an interdisciplinary field where the principles of the physical sciences are employed to define and explore living things, often for the purposes of medical application. “As an interdisciplinary department, Medical Biophysics is a ‘big mix’”, says Lawrence.“ Collaboration is the key factor here because we involve a lot of transdisciplinary research from medical imaging, cell biology, physiology, kinesiology and many other areas to apply them directly to patient care.”

What Lawrence loves most in his academic life now is the focus on translational research and the chance provided by his lab to “build something from scratch”. “Even as a kid I enjoyed designing little things. My dad, an electrical engineer, inspired me to build something from common materials and taught me how to create things from the ground up. I find all those skills extremely helpful for what I am focusing on in my lab.”

The portable device that Lawrence currently is building will help surgeons perform cancer surgery more successfully. The technology, which is called 3D photoacoustic tomography (PAT), will be able to improve outcomes for cancer patients who need surgery. Especially promising is the use of this device in treating breast cancer.

At present, there is an option for some breast cancer patients to undergo a lumpectomy, which is a breast-conserving surgical technique where only tumor(s) are removed (unlike a mastectomy, in which a surgeon removes the entire breast). In a lumpectomy, the tumour is excised with a margin of healthy tissue ranging from a 2-mm to a 10-mm width.

Lawrence Yip - BCSC Breast Cancer Funded Researcher“The key thing for the surgeon is to remove as much tumor tissue as is possible. If a substantial mass of tumor is left in the breast, it will grow back in to another tumor. To ensure complete tumour removal, the surgeons take a layer of healthy tissue right around of the whole tumor. A margin of tissue should be clean, that is, not have any cancer cells. Clear margins are the standard for lumpectomy surgery.”

However, sometimes additional surgery may be required after a lumpectomy. As Lawrence explains, detection of the margin can be difficult because current techniques used to guide excision are often insufficient. “We need to wait for the pathology report. After the surgery is done, the pathologist examines the excised tumor to make sure that its margins have no cancer cells. It takes time. Unfortunately, current lumpectomy re-excision rates average 25% of the time when pathology finds a tumour in the margin after surgery.”

The technique Lawrence is developing will provide a way to see the margin in the operating room. “PAT is a hybrid imaging technique that combines the strengths of ultrasound and optical imaging while using non-invasive laser light. This technique is quite novel. It is around 20 years now in active research and is not yet a clinical standard. Ultrasound looks at the differences in the density of materials by using sound, while light imaging can look at very specific substances. Using light, you can target various things just by changing what color light you use. With this method, 3D images with high contrast, high resolution and excellent penetration depth can be achieved while maintaining a low cost.”

What does this system look like and how does it work? “Since PAT is a portable system, it is not as big as, say, an MRI machine. PAT can be wheeled down to any operating room or wherever we need to scan what we need. The workflow with PAT will be as follows: the surgeon takes out the tumor, brings it to the PAT system, scans the material and gets the image right away, which shows if the margins are cancer-free or if the tissue must be excised more. The entire process will take 5 -10 min while the patient is in the operating room. So, this system will help surgeons ensure that complete tumour removal is achieved on the first try. No re-excision will be necessary.”

Lawrence hopes to use the system in the operating room shortly to define its applicability with real breast tumours and to compare its performance with previous generation PAT systems. “The hardest thing in my field is when you finish something, and you think it should work, but it doesn’t. You should step back and try something different. Persistence is highly important in research. All of us in the lab work hard and hope that our systems will work effectively from the first try and will be used in clinical practice soon.”

Support researchers like Lawrence Yip and others by considering a donation to the Breast Cancer Society of Canada. Find out how you can help fund life-saving research, visit

Lawrence Yip’s story was transcribed from interviews conducted by BCSC volunteer Natalia Mukhina – Health journalist, reporter and cancer research advocate

Natalia Mukhina - Health JournalistNatalia Mukhina, MA in Health Studies, is a health journalist, reporter and cancer research advocate with a special focus on breast cancer. She is blogging on the up-to-date diagnostic and treatment opportunities, pharmaceutical developments, clinical trials, research methods, and medical advancements in breast cancer. Natalia participated in numerous breast cancer conferences including 18th Patient Advocate Program at 38th San Antonio Breast Cancer Symposium. She is a member of The Association of Health Care Journalists.


Trying to stop early breast cancer from progressing

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Milica Krstic, BCSC funded ResearcherWhen asked about the top skills needed to be a successful researcher in her field, Milica Krstic lists them as follows, “Being creative and coming up with interesting and creative research questions is very important. You should read the latest papers and be able to make connections with how you can apply that in your own research.”

Milica Krstic works at the London Regional Cancer Program under the supervision of Drs. Ann Chambers and Alan Tuck. She is pursuing her PhD in the Department of Pathology and Laboratory Medicine at Western University. Milica has been studying transcriptional regulation in early breast cancer throughout her PhD studies.

Thinking back on the starting point of her research, Milica says she enjoyed working in areas related to molecular biology and biochemistry during her undergraduate degree at the University of Windsor. When it came time to choose what to study further, it was Dr. Ann Chambers who influenced Milica’s decision to enter the breast cancer field. “As an undergrad, I was aware that a lot of different areas exist within cancer research. Meeting Dr. Chambers, a distinguished oncology scientist, and learning about the kind of work that her lab is conducting influenced me to pursue breast cancer research specifically. I really liked her use of experimental animal models and the clinical focus of her work.”

Milica has been studying a transcription factor called TBX3 in the early stages of breast cancer. This protein is believed to promote malignancy of tumor cells. “We know that TBX3 levels are elevated in several types of cancer, but its role in breast cancer progression is not well understood. We are looking at the underlying mechanism and trying to elucidate how that happens and whether these events are clinically relevant.”

Milica’s research suggest that TBX3 promotes progression of early-stage breast cancer, and Milica underlines that this is a big clinical problem. Ductal carcinoma in situ (DCIS) is a very early stage of breast cancer in which some cells of the breast have become cancerous, but have not invaded the surrounding breast tissue. “Unfortunately, lots of patients progress with DCIS preinvasive lesions. Women with DCIS have a 10-times-higher risk for developing invasive cancer than women without a history of DCIS.”

Milica has done a lot of genomics work to look at the targets of TBX3. She hopes to find something that can be used to predict the probability of breast cancer advancement from Stage 0 (when cancer cells remain within their original location) to Stage I: “We are trying to find out those molecular changes that occur when breast cancer goes from the non-invasive to invasive stage. TBX3 can be thought of as a ‘master regulator’ influencing gene expression within a cancer cell. If we understand the way TBX3 promotes cancer progression through these transcriptional changes, it allows us to stratify patients into risk groups and treat these patients accordingly.”

Approximately 16% of patients with low grade DCIS and about 60% with the high grade will progress to invasive cancer, but these patients are all receiving identical treatment. “Lots of studies have reported that several patients with early breast cancer are actually over-treated. They are going through difficult, invasive and expensive treatment they don’t need. If we succeed with our research, there will be the possibility to treat those patients who really need the therapy and prevent them from progressing to deadly cancers.”

During the experimental part of her research, Milica has worked with two variants of TBX3. “These are two different isoforms. Before I started the experiments, there was no knowledge of any differences between these two variants. In fact, there is a drastic difference between them that can be directly linked to functional differences, and has been validated using clinical patient data as well. I hope that in about six months the results of my experiments will be published.”

“I have faced a lot of challenges over the past couple of years. The end of the PhD is the hardest stage. The experiments that I do need to be very critically thought out. Everything needs to have a purpose, so I can tie up all of the loose ends. I am currently focusing on publishing the multiple stories I’ve been working on throughout my studies. The excellent thing about research is that the deeper you dive into the topic, the more research questions arise that encourage me to go further, the more exciting the story gets.”

Support researchers like Milica Krstic and others by considering a donation to the Breast Cancer Society of Canada. Find out how you can help fund life-saving research, visit

Milica Krstic’s story was transcribed from interviews conducted by BCSC volunteer Natalia Mukhina – Health journalist, reporter and cancer research advocate

Natalia Mukhina - Health JournalistNatalia Mukhina, MA in Health Studies, is a health journalist, reporter and cancer research advocate with a special focus on breast cancer. She is blogging on the up-to-date diagnostic and treatment opportunities, pharmaceutical developments, clinical trials, research methods, and medical advancements in breast cancer. Natalia participated in numerous breast cancer conferences including 18th Patient Advocate Program at 38th San Antonio Breast Cancer Symposium. She is a member of The Association of Health Care Journalists.

Introducing New Breast Cancer Research Trainee Scholarships in London

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We are pleased to announce 13 new graduate student scholarships at Western University for the 2017-2018 academic year.  These awards are supported by the Breast Cancer Society of Canada’s very generous commitment to the Pamela Greenaway-Kohlmeier Translational Breast Cancer Research Unit (TBCRU) at London Health Sciences Centre’s London Regional Cancer Program (LRCP).

Translational research unit student researchers

Trainees compete annually for these awards.  Their applications are assessed on the scientific quality of their project, their academic record, the relevance of the project to translational breast cancer research and the strength of their mentor.  This year, seven of the trainees are PhD students, five are MSc students and one is enrolled in the joint PhD-MCISc (CAMPEP) (Commission on the Accreditation of Medical Physics Educational Programs) Accredited Program, which prepares trainees to become medical physicists.

These students are enrolled in six departments Western University (Anatomy & Cell Biology, Biochemistry, Biomedical Engineering, Chemistry, Medical Biophysics, and Pathology & Laboratory Medicine).  They are working in Lawson Health Research Institute laboratories  at LRCP, St. Joseph’s Health Care London, as well as in laboratories at Western University.

Their research projects cover a wide range of important breast cancer research, ranging from basic biology of breast cancer cells to clinical studies, and all of their research is focused on improving care for breast cancer patients.  You can learn more about our trainees and details of their projects at this link.   Over the coming year, the students will provide updates on their research progress here on the BCSC research blog.

Congratulations to our trainees – and thank you to the Breast Cancer Society of Canada and its supporters!

Ann Chambers, PhD

Director of the Pamela Greenaway-Kohlmeier Translational Breast Cancer Research Unit, funded by the Breast Cancer Society of Canada

Support life-saving breast cancer research

3D Surface Imaging Technique for Breast Cancer

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My name is Olivia Tong and I am a MESc candidate in the Department of Biomedical Engineering under Drs. Jeffrey Carson and Mamadou Diop at Lawson Health Research Institute.

BCSC Researcher - Olivia Tong - 3D Surface Imaging Technique for Breast CancerWe are developing a non-contact scanner that can monitor the blood oxygen level in the tumor during chemotherapy. The success of this project will lead to a new diagnostic method that can quickly identify the most effective chemotherapy drug for each breast cancer patient. You might have seen Lawrence Yip’s blog posts regarding Photoacoustic Imaging Research. For this scanner, we also use photoacoustic imaging to detect breast tumors. As an improvement, we are building a non-contact system. I am working on a component of this non-contact scanner that captures the 3D shape of the breast using 3D surface imaging technique. The 3D information of the breast is important for reconstructing the photoacoustic images collected by the other component of the scanner.

The support of TBCRU enabled me to purchase a commercial structured light scanner for the development of my system. My next step is to evaluate the performance of my system on a small group of human subjects before integrating my component into the non-contact scanner. For this project, we also collaborate closely with clinicians at the breast cancer center at St. Joseph’s Hospital and researchers at McMaster University.

This May, I have the opportunity to meet with our collaborators and learn more about biomedical optics. I am very grateful to be supported by TBCRU and work for this amazing project.

Personalized radiation from the inside-out

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My name is Justin Michael and I’m an MESc candidate studying in the Department of Biomedical Engineering under Dr. Aaron Fenster in the Robarts Research Institute.

Just weeks after Canada’s 150th birthday, complete with fireworks and concerts, I travelled to our nation’s capital to present at a scientific conference on a distinctly Canadian project. I presented technology to improve the accuracy of a relatively new breast cancer treatment. Pioneered at Toronto’s Sunnybrook hospital, the treatment implants radioactive “seeds” in the patient’s breast, delivering personalized radiation from the inside-out in a single visit. It replaces the weeks-long standard approach of delivering radiation from the outside-in, reducing the burden of treatment to the patient. Using ultrasound imaging and simple robotics, we’ve developed tools to help doctors implant the seeds more easily and more accurately.

Justin Michael

From left to right: Justin Michael, TBCRU graduate student; Luc Beaulieu, Professor – Laval University; Aaron Fenster, Imaging Scientist & TBCRU Supervisor – Western University; Deidre Batchelar, Medical Physicist & Adjunct Professor – University of British Columbia Okanogan

Working under Dr. Aaron Fenster in London’s Robarts Research Institute, we’ve collaborated closely with clinicians and researchers at the cancer center in Kelowna, BC. Their center serves patients from throughout the BC interior, some of whom travel up to 350 km for treatment, making shorter radiation especially important. In addition to partnering with researchers in Canada’s West, the research builds on previous technology developed with physicists at Quebec’s Laval University in Canada’s East.

In Ottawa, I showed the tools we’ve built are nearly ready. Our next step is testing on surgical simulators developed at the University of Calgary before moving into clinical trials.

Through research touching four provinces and three time-zones, we’re working to improve options for patients battling breast cancer. Though the Canada Day fireworks have come and gone, researchers in London and across the country still have plenty to celebrate.

Thank you to the BCSC for their support.

Justin Michael, MESc Candidate

Miss Teenage Toronto supports BCSC

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Miss Teenage Toronto 2017 (Alexia Antonio) has been very active this July, volunteering and running fundraising events across Toronto in support of a number of different charities, including ours! Alexia will be hosting a number of tables in the Bay Adelaide Centre concourse, on July 25, 26 and 27, between 9am and 5pm. She will be located across the Second Cup in the PATH concourse for the centre.

Alexia Antonio BCSC FundraiserAlexia has prepared dozens of gift baskets to help support her fundraising efforts. With every donation of $5, $10 and $20, donors are eligible for different types of gift bags with various beauty products enclosed – 100% of all proceeds will go the Breast Cancer Society Of Canada, funding life-saving breast cancer research.

We are looking forward to hearing more about Alexia BCSC fundraising event from her directly, when we interview her about her experience fundraising for us and fund out why she has chosen the Breast Cancer Society of Canada as one of her charities of choice.

More about Miss Teenage Toronto 2017,
Alexia is a kind and an open-minded young woman who is determined to achieve her life goals while making positive contributions in the world. Alexia currently hold the title of Miss Teenage Toronto and strongly supports women’s needs and the empowerment and equality for all women. Alexia aims to spread the message of courage, strength and confidence through her Beauty Inside campaign. Alexia is currently attending York University and her hobbies include swimming, reading and performing in Shakespearean plays. Alexia has a passion for fencing and is currently on the York University fencing team and dreams of competing in the Olympics.

Follow Alexia during her fundraising event for BCSC on
Facebook,  Instagram and her blog for all the up to the moment fun details over the next three days as she supports funding life-saving breast cancer research.  Because #ResearchMatters

Finding cancer: Improving x-ray detector technology for earlier detection of breast cancer

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Hello! I’m Tomi Nano, a PhD candidate in the department of Medical Biophysics at Western University. I work at Robarts Research Institute in Dr. Ian Cunningham’s lab on development of new x-ray detector designs and measurements of their performance.

Tomi Nano, a PhD candidate in the department of Medical Biophysics at Western UniversityThe Pamela Greenaway- Kohlmeier Translational Breast Cancer Unit (TBCRU) Traineeship Program has supported my research in improving detector technology performance for earlier detection of breast cancer. Women who enrol in mammography screenings have up to 40% reduced risk of death from breast cancer, but since mammograms require exposure to radiation, detectors should produce high-quality images with the least amount of radiation so as to minimize the risk to patients. The aim of my research project is to develop an “ideal” x-ray detector which produces the highest-quality images with little radiation.

Improvements in image signal-to-noise ratio (SNR) are known to improve breast cancer detection. During my traineeship, our lab has developed a detector design that produces images with higher SNR of small features and fine detail which are important for early detection of breast cancer. Better visualization of fine detail in mammograms should help radiologists more accurately identify cancer. To further understand the clinical process of breast cancer screening, I have begun an observership at St. Joseph’s Hospital with Dr. Anat Kornecki. Our goal is to apply our new technological advancements to address the needs clinicians have for detecting breast cancer earlier.Tomi Nano

The support from TBCRU enabled me to share my discoveries with other scientists and clinicians at the 2017 Mammography Workshop and Imaging Winter School conference organized by the Canadian Organization of Medical Physicists (COMP). In addition to discussing my translational breast cancer research with physicists, radiologists and technologists, this meeting provided an opportunity to establish future collaboration with leading Canadian scientists, such as Martin Yaffe from Sunnybrook Hospital in Toronto and Jean Seely from the Department of Diagnostic Imaging at Ottawa Hospital.

Thank you TBCRU and BCSC for supporting translational breast cancer research!

Breast cancer cell migration research

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Hello, everyone! My name is Sami Khan and I’m an MSc candidate in the Department of Anatomy and Cell Biology at Western University. I work at London Cancer Regional Program under the supervision of Dr. Alison Allan. Our lab focuses on breast cancer metastasis: the process by which cancerous cells can leave the breast and establish tumours in other organs.

Sami Khan BCSC funded Breast Cancer ResearcherOne of the most common and deadly sites of breast cancer metastasis is the lung. For my project, I am currently investigating a family of proteins produced by the normal lung called selectins, and how they may play a role in helping breast cancer cells spread to and grow in the lung as metastatic tumours. To date, we have promising results that suggest selectins are involved in the migration (movement) of breast cancer cells and we are now investigating the mechanism by which this happens. Successful identification of a common mechanism by which the different selectins act will provide a new potential therapeutic target in limiting the spread of breast cancer to and from the lung.

This April, I had the opportunity to present my research at the 108th Annual Meeting of the American Association of Cancer Research in Washington, D.C. With over 20,000 attendees at the conference, it was an amazing opportunity to interact with scientists and clinicians from around the world, and learn about the breadth of research being conducted in the field. Returning to the lab with my newfound knowledge and expert advice, I am excited to see what we can accomplish next in our goal towards curing breast cancer.

Thank you to BCSC for your trainee support!

Sami Khan, MSc Candidate

Pamela Greenaway-Kohlmeier Translational Breast Cancer Research Unit, London Health Sciences Centre

Developing a molecular imaging technique using MRI

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Hello, My name is Yonathan Araya, I am a PhD candidate in the Department of Medical Biophysics at Western University. I work in the Imaging Research Laboratories at Robarts Research Institute under the supervision Dr. Timothy Scholl.

Yonathan Araya Breast Cancer ResearcherDr. Scholl’s lab focuses on developing advanced magnetic resonance imaging (MRI) techniques for use with novel molecular imaging probes of cancers. These molecular imaging probes are important tools to help oncologists map enzymes, proteins and amino acids, which are difficult to detect using conventional MRI methods and are linked to different cancers. The new methods (collectively known as molecular imaging) would help to assess solid tumours and measure their response to treatment.

The focus of my project has been developing a molecular imaging technique using MRI for the detection of specific proteins and cell-based interactions in breast cancers. I exploit the specific magnetic field dependence of tissues and contrast agents using our fast field-cycling magnet (which we call ‘dreMR’) to assess the metabolism and inflammatory response of solid breast cancer tumours. Last year, I described in our findings that there was a weak magnetic field dependence of tissues at clinical magnetic field strengths and that we can exploit this information to characterize cancerous tissues. The work was submitted to a scientific journal.

Currently, our lab is interested in measuring the up-regulation of serum albumin and the increased inflammatory response associated with the poor prognosis breast cancers and quantifying the changes in response to therapeutic treatment. This work is ongoing at the University Hospital and Robarts Research Institute.

Thank you for your trainee support!

– Yonathan Araya, PhD candidate

MRI cell tracking for breast cancer

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Hi, My name is Ashley Makela and I am a PhD candidate in the department of Medical Biophysics at Western University. I am working at Robarts Research Institute in Dr. Paula Foster’s lab where our main focus is to develop magnetic resonance imaging (MRI) techniques to “track” cells.

Ashley Makela - Breast Cancer ResearcherMy research involves using this MRI cell tracking specifically in breast cancer. Doing so, we can image specific cells called tumour associated macrophages (TAMs) and with this, we can get both information about the primary tumour and also visualize where the cancer spreads within the body (metastasis). We believe these cells are important to learn more about; their presence helps the tumour grow, allows the cancer to metastasize and they are associated with a poor prognosis in the majority of breast cancer cases. This research may produce important information about the influence of TAMs on tumour growth and metastatic spread and give insight on how to use this information to aid in detection, prognosis and treatment evaluation.

I’ve recently published my first research article and I’m looking forward to presenting my findings in Honolulu this April at the International Society for Magnetic Resonance in Medicine.

Thank you to BCSC for your trainee support.

– Ashley Makela, PhD Candidate

Pamela Greenaway-Kohlmeier Translational Breast Cancer Research Unit, London Health Sciences Centre