Dr. David Hsiang, MD

Dr. David Hsiang, MD

Assistant Clinical Professor
Department of Surgery
Surgical Oncology Division

Dr. David Hsiang, MD is a breast health care physician and scientist who is focused on the evaluation of advanced imaging techniques, specifically diffuse optical scanning, as a method for detecting breast cancer and for quickly determining if a patient is benefiting from the chosen therapy. These advanced imaging techniques use light to instead of X-rays and are being evaluated in studies conducted with Drs. Butler, Mehta, Tromberg, and Su.

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Research Profile

1. What is your breast cancer specialty?

Translational oncology, which involves developing new technologies in the field of Optics and MRI. These are two different screening mechanisms. MRI is magnetic; while Optics is light (Dr. Hsiang is the principal investigator for UC Irvine 's laser study.). Translational oncology is about trying out new, cutting edge treatment options, like the neoadjuvant clinical trial. Neoadjuvant treatment involves shrinking the tumor using chemotherapy prior to performing surgery. When we stared the clinical trial, the treatment was not standard and now it is used more and more commonly.

There is also translation is surgery with a growing link between bed to bench-side, which means bringing the inventions of UC Irvine 's scientists to the clinic and both finding uses and using the technology in clinic. In other words, bridging science and clinic.

2. Why is this an important part of breast cancer care?

This is important for all cancer care. The cause of cancer is still unknown and the frequency or incidence rate is increasing. That is definitely a health problem that we need to worry about. You need to move ahead. Medicine is not stagnant. If we don't do this form of translational research, the field of medicine will not move forward. We'll keep doing the same things we've been doing and we are already proving that doing the same things over and over are not controlling the disease. The incidence is actually increasing and the age of women with breast cancer is decreasing.

3. How is this different then what might be offered in the community (outside of UC Irvine )?

The community does not have enough clinical trials and the translational type of treatment and research that the UC Irvine Breast Group has. The UC Irvine Breast Group also has a research/career interest solely on breast. Other surgeons may have other interests. The UC Irvine Breast Group also has an academic motivation, which entails an ongoing quest for knowledge. We attend national conferences to discuss cutting edge findings with other physicians, we publish our own innovative findings, and this creates an even greater vested interest in the outcome of patients.

4. Specifically, what is it?  (description of the treatment, procedure, study, etc.)

Laser study a study using light, but the light is from laser source. It is a very harmless light that doesn't burn in any sense. The reason we're using laser source is that the light signal is very pure. Because of this we can get an optical biopsy or optical signature of the tumor. The goal is to shine the light on the breast and by using the native characteristics of the breast, be able to tell if the abnormal area is malignant without having giving you contrast. This is very different from MRI where the patient would still have to use receive an IV. The ultimate goal would be to do an optical biopsy where there is no invasive component whatsoever.

The laser would be in place of the mammogram. Right now we are using one pair of detectors and emitters in the study. The next step is to extrapolate that and use thousands or millions of detectors to create an image. The goal is to create a noninvasive breast scanner that has the ability to perform optical biopsies.

5. What will my (the patient) experience be like with you?

      Listen and gather the history
      Review radiological films and pathology report
      Perform physical exam
      Formulate the plan for treatment

The patient will be active participant and the plan must be agreed upon by both parties. I don't like to dictate. I want it to be an agreed upon treatment plan. Patients are not passive in my treatment. This is different from the community in that treatment may be more dictated. We work together and I both welcome and involve patient input for several reasons:

1.    The patient has disease, not the doctor.
2.    Active participants in their health care get better results, than if they are passive.
3.    Benefits the patient psychologically.

Together we are both working together to same goal good treatment and health.

6. What else should I know... Screening/Diagnositic?

Whoever joins the laser study is at the forefront nationwide of this modality of diagnosis. There is nobody else in the whole nation that has this program. UC Irvine , the Beckman Laser Institute is the administrative core / Optics headquarters for NTROI (Network for Translational Research Optical Imaging Network). NTROI is a 7.1 million dollar multi-center grant where the biggest universities (including Ivy League) are involved in developing the standard of optical photo-medicine in the United States. In other words, won't be able to go anywhere else in the US for this and that really makes UC Irvine stand out.

About NTROI:
The Breast Cancer Multi-Dimensional Diffuse Optical Imaging (BCDOI)-Network for translational research optical imaging (NTROI) is a Specialized Research Resource Center (U54) funded by the National Cancer Institute. The NTROI is administered through the Beckman Laser Institute and Medical Clinic at University of California, Irvine. The purpose of the BCDOI NTROI is to encourage the development of new breast cancer detection methods by leveraging the expertise of several academic, government and industry team members.

NTROI research focuses on creating new instruments specifically designed for detecting breast cancer and monitoring breast cancer therapies. These technologies are based on optical imaging and the integration of optics with MRI and x-ray mammography. The network will validate instrument performance and standardize how images are acquired and analyzed. In addition, the NTROI will coordinate multi-center clinical trails, the formation of commercial partnerships, and provide participants with access to human and animal protocols, clinical data, molecular probes, and algorithms for data analysis.

7. What is the best way for potential patients to reach you?

By phone and/or email.

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