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Towards the simulation of breast surgical lumpectomy and surgery planning through an isogeometric numerical analysis approach

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Cosmetic assessment of surgical breast lumpectomy

Early stage breast tumours are often removed by lumpectomy with possible distortion of patient's breast. EU scientists proposed a preoperative computational tool for cosmetic outcome assessment.

Fundamental Research
Health

Breast cancer is the most common cancer with half a million new cases registered in Europe every year. The treatment at the early stages involves breast preserving surgery (lumpectomy) followed in some cases by chemotherapy and/or radiotherapy. Evaluation of the aesthetic outcome of breast conserving therapy found that 6 % of patients receive a poor cosmetic result and up to 30 % of patients are dissatisfied with their appearance after surgery. The EU-funded IBESUP project attempted to develop computer simulation tools to evaluate the cosmetic outcome of the surgery. IBESUP proposed an integrated numerical framework that can simulate the effects of surgical treatment over the extended period of recovery. Researchers developed a three-dimensional, mathematical and computational modelling framework simulating breast tissue deformations and physiological tissue recovery after surgery. The modelling involved two powerful numerical methods from the applied mechanics field: the finite element method and the isogeometric analysis method. The effectiveness and accuracy of the proposed simulation framework was illustrated using patient-specific representative data. Researchers analysed numerical data on wound healing and contraction involving real patient-based MRI-derived breast geometries. The final predictions of the breast shape were validated by comparison to post-operative follow-up photographic and surface scans from four patients. The IBESUP project has achieved their important goal of successfully developing a novel validated in-silico modelling simulator for breast-conserving surgery. The proposed framework includes consideration of the changes associated with the recovery and wound healing processes. Furthermore, this developed simulation could serve as the foundation for the future development of other clinically relevant surgical simulators.

Keywords

Cosmetic assessment, lumpectomy, breast tumour, IBESUP, modelling framework

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