Determining the feasibility of assessing the adequacy and immunophenotype of human breast core needle biopsies using molecular and H&E fluorescence imaging via deep-UV optical microscopy

Abstract

Histopathology techniques have not advanced with related technological innovations made in the last few decades. As a result, they are needlessly time consuming, labor intensive, and are not adapted for core needle biopsies (CNBs), an increasingly common, minimally intensive biopsy technique. CoreView, a novel histopathology-on-a-chip device under development in the Seibel Laboratory, can solve these problems by automatically handling and imaging fresh CNBs at the point-of-care. To succeed as a histopathology device, CoreView needs a stock of UV-compatible stains and immunohistochemistry (IHC) biomarkers to enable fresh tissue imaging with deep-UV light. Due to its importance in breast cancer, one of the cancers most frequently biopsied with a core needle, this study focuses on staining the HER2 antigen with a novel UV-compatible biomarker. To assess the biomarker’s accuracy and effectiveness in CoreView, fresh human breast cancer specimens and formalin fixed paraffin embedded HER2+ and HER2- tissue slides are imaged. Additionally, each of these tissues undergo gold standard histopathology to compare the amount of HER2 staining and to determine if the stains used in CoreView affect downstream histopathology. Using a novel HER2 IHC score prediction plugin for ImageJ and comparative diagnoses by our collaborating breast cancer pathologist, it was determined that the HER2 biomarker appears to stain the cell membranes of fresh breast cancer biopsies imaged with DUV microscopy. It was also determined that all the stains used to complete this imaging did not disrupt downstream histopathology. For the most accurate conclusion, this biomarker must be tested on a fresh HER2+ breast cancer sample, which was never available during this study. Furthermore, more mechanical work needs to be completed for the CoreView system to produce images a pathologist can use to assess the adequacy of its samples.