Abstract
Aim To evaluate the feasibility of a newly developed prototype MRI projection mapping (PM) system for localization of invasive breast cancer before breast-conserving surgery. Methods This prospective study enrolled 10 women with invasive breast cancer. MRI was performed in both prone and supine positions. The tumor location was drawn on the breast skin using palpation and sonography while referring to the prone MRI (i.e., a conventional method). A maximum intensity projection image generated from the supine MRI was projected using our PM system, and the tumor location was drawn. The PM system consisted of a projector and a camera and was used to measure the shape of the breast surface using the structured light method. Breast-conserving surgery was performed based on the conventional method. We compared the tumor size and location between the PM and conventional methods or pathology. Results There were no significant differences in the maximum diameters of invasive cancers between the PM system and the conventional method or pathology. The maximum discrepancy in tumor location between the PM and conventional method was 3–8 mm. Conclusions This PM system may support breast-conserving surgery by showing the tumor size and location on the breast surface.
Highlights
Breast-conserving surgery has been established as a standard treatment for relatively small breast cancer [1]
MRI is the best modality for depicting the spread of breast cancer, including ductal carcinoma in situ (DCIS), which spreads in three-dimensional (3D) directions [4, 5]
We focused on invasive breast cancer identified by US to observe the accuracy of this system because the US approach used in the conventional method can identify invasive tumors well, but not necessarily DCIS
Summary
Breast-conserving surgery has been established as a standard treatment for relatively small breast cancer [1] In such surgery, a positive surgical margin is associated with local recurrence and poor prognosis [2, 3], while it is required to maintain the shape of the breast as much as possible. Contrast-enhanced MRI is usually performed before breast-conserving surgery to estimate the spread of breast cancer accurately. The surgical margins for breast-conserving surgery are determined conventionally by palpation and US while referring to MRI findings in the operating room (OR) (i.e., the conventional method). The location and spread of breast cancers must change from the time of MRI scans to the OR [6, 7]
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