Abstract
Breast shapes are affected by gravitational loads and deformities. Measurements obtained in the standing position may not correlate well with measurements in the supine position, which is more representative of patient position during breast surgery. A dual color 3D surface imaging system capable of scanning patients in both supine and standing positions was developed to evaluate the effect of changes in body posture on breast morphology. The system was evaluated with breast phantoms to assess accuracy, then tested on ten subjects in three body postures to assess its effectiveness as a clinical tool. The accuracy of the system was within 0.4 mm on average across the model. For the human study, there was no effect of body posture on breast volumes (p value > 0.05), but we observed an effect of completeness of breast scans on body posture (p value < 0.05). Post-hoc tests showed that the supine position and the standing position with hands at the waist differed significantly (p value < 0.05). This study shows that the system can quantitatively evaluate the effect of subject postures, and thereby has the potential to be used to investigate peri-operative changes in breast morphology.
Highlights
In conventional practice, surgeons plan breast surgeries by consulting radiographic images such as two-dimensional mammograms and breast MRI images to identify tumour locations within the breast
The 3D-SI system was first tested on the 3D printed breast phantoms, and on ten human subjects
The print quality of the breast phantom was evaluated based on the differences between (1) the measured values in the computed tomography (CT) reconstructed model and the computer model, and (2) the caliper measurements and the computer model
Summary
Surgeons plan breast surgeries by consulting radiographic images such as two-dimensional mammograms and breast MRI images to identify tumour locations within the breast. These radiographic images are taken in either the standing or prone position and do not represent the breast position during surgery. Surgeons need to mentally transform the radiographic images to information that matches the surgical scenario in the supine position This is challenging for oncoplastic and reconstructive surgeries because the technique used for reconstruction depends on the tumour location and the tumour to breast size ratio[2]. The technical challenges of anticipating tumour location in order to completely remove it and reconstruct the breast affect the success of such surgeries and leads to variable cosmetic results and patient satisfaction
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