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A self-assembled fluorescent contrast agent for imaging-guided simultaneous resection of breast tumors and metastatic lymph nodes in surgery.

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Title: A self-assembled fluorescent contrast agent for imaging-guided simultaneous resection of breast tumors and metastatic lymph nodes in surgery.
Authors: Ma, Xiao-Qing1,2 (AUTHOR), Wang, Li-Ying1 (AUTHOR), Zhang, Yu-Xing1,3 (AUTHOR), Zhang, Ni-Yuan1 (AUTHOR), Li, Hao-Ze1 (AUTHOR), Liang, Jian-Xiao1 (AUTHOR), Liao, Yu-Si1 (AUTHOR), An, Hong-Wei1 (AUTHOR) anhw@nanoctr.cn, Zhang, Xi-Liang1,2,3 (AUTHOR) doctor_zxl1978@126.com, Wang, Hao1,4,5 (AUTHOR) wanghao@nanoctr.cn
Source: Biomaterials. Aug2026, Vol. 331, pN.PAG-N.PAG. 1p.
Subjects: Breast cancer surgery, Sentinel lymph nodes, Surgical margin, Lymphatic metastasis, Nanostructures, Fluorescent probes, Near infrared spectroscopy, Diagnostic imaging
Abstract: Accurate intraoperative margin assessment and reliable detection of metastatic sentinel lymph nodes (SLNs) remain critical challenges in breast cancer surgery. We developed sa-FCA, a novel XIAP-targeting near-infrared fluorescent probe that achieves enhanced tumor specificity and sensitivity, along with a prolonged imaging window, via tumor-selective cascade activation and in situ self-assembled nanostructures. In a mouse model of breast cancer, sa-FCA demonstrated precise tumor localization, sensitive detection of metastatic SLNs, and identification of spontaneous pulmonary metastases. Clinical evaluation using human specimens showed excellent discrimination between tumor and benign tissues such as fibroadenoma (n = 252 patients, 99.59% sensitivity and 97.37% specificity), with clear lesion delineation. Furthermore, it accurately distinguished between metastatic and non-metastatic SLNs, with a sensitivity of 98.18% and a specificity of 92.31% (n = 69). By significantly improving metastatic SLN detection, sa-FCA overcomes the intraoperative diagnostic delays inherent in conventional pathology and facilitates immediate surgical decision-making. The ability of sa-FCA to precisely target tumors, differentiate fibroadenoma, and identify metastatic nodes allows for complete tumor resection with maximal normal tissue preservation, thereby enhancing both oncological safety and cosmetic outcomes. These findings establish a new paradigm for image-guided breast cancer surgery and promote the clinical translation of fluorescence-guided interventions. • sa-FCA achieved long-term stable imaging window through in situ self-assembly nanostructures. • sa-FCA has a tumor cell selectivity up to 12.20 times. • sa-FCA enabled accurately targeted lung metastases (TBR = 7.1) and lymph-node metastases (TBR = 8.2). • sa-FCA achieves 99.59% sensitivity and 98.18% sensitivity in human breast tumor detection. [ABSTRACT FROM AUTHOR]
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Database: Engineering Source
Description
Abstract:Accurate intraoperative margin assessment and reliable detection of metastatic sentinel lymph nodes (SLNs) remain critical challenges in breast cancer surgery. We developed sa-FCA, a novel XIAP-targeting near-infrared fluorescent probe that achieves enhanced tumor specificity and sensitivity, along with a prolonged imaging window, via tumor-selective cascade activation and in situ self-assembled nanostructures. In a mouse model of breast cancer, sa-FCA demonstrated precise tumor localization, sensitive detection of metastatic SLNs, and identification of spontaneous pulmonary metastases. Clinical evaluation using human specimens showed excellent discrimination between tumor and benign tissues such as fibroadenoma (n = 252 patients, 99.59% sensitivity and 97.37% specificity), with clear lesion delineation. Furthermore, it accurately distinguished between metastatic and non-metastatic SLNs, with a sensitivity of 98.18% and a specificity of 92.31% (n = 69). By significantly improving metastatic SLN detection, sa-FCA overcomes the intraoperative diagnostic delays inherent in conventional pathology and facilitates immediate surgical decision-making. The ability of sa-FCA to precisely target tumors, differentiate fibroadenoma, and identify metastatic nodes allows for complete tumor resection with maximal normal tissue preservation, thereby enhancing both oncological safety and cosmetic outcomes. These findings establish a new paradigm for image-guided breast cancer surgery and promote the clinical translation of fluorescence-guided interventions. • sa-FCA achieved long-term stable imaging window through in situ self-assembly nanostructures. • sa-FCA has a tumor cell selectivity up to 12.20 times. • sa-FCA enabled accurately targeted lung metastases (TBR = 7.1) and lymph-node metastases (TBR = 8.2). • sa-FCA achieves 99.59% sensitivity and 98.18% sensitivity in human breast tumor detection. [ABSTRACT FROM AUTHOR]
ISSN:01429612
DOI:10.1016/j.biomaterials.2026.124060