Does Confocal Laser Endomicroscopy enable identification of positive and negative surgical margin during breast cancer surgery.

During the lumpectomy procedure, patients will be injected with IV fluorescein sodium (7.5ml of 10% solution). The endomicroscope will be used to image the inside of the cavity after removal of the excised lump. The surgeon will be blinded to the images from the endomicroscope for this procedure and imaging will not affect patient standard of care. Tissue excised during wide local excision with cavity shaves will be topically stained with fluorescein, acriflavine and acridine orange, and then imaged with a handheld confocal endomicroscope. Images will be collected and assessed for potential involved margins for each piece of tissue excised during the procedure. Tissue will then be fixed and processed using standard pathology processes. The ability of confocal endomicroscopy to identify potential involved margins will be assessed against the results from pathology. The surgeon and pathologists will be blinded to the confocal imaging results, so there will be no deviation from normal standard of care for patients in this study. The in vivo and ex vivo confocal endomicroscopy will be done by an Optiscan technician who is trained in the use of the endomicroscope.