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A Patient-Specific 3D-Printed Form Accurately Transfers Supine MRI-Derived Tumor Localization Information to Guide Breast-Conserving Surgery
- Source :
- Annals of Surgical Oncology. 24:2950-2956
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Wire-localized excision of nonpalpable breast cancer is imprecise, resulting in positive margins 25-30% of the time.Patients underwent preoperative supine magnetic resonance imaging (MRI). A radiologist outlined the tumor edges on consecutive images, creating a three-dimensional (3D) view of its location. Using 3D printing, a bra-like plastic form (the Breast Cancer Locator [BCL]) was fabricated, with features that allowed a surgeon to (1) mark the edges of the tumor on the breast surface; (2) inject blue dye into the breast 1 cm from the tumor edges; and (3) place a wire in the tumor at the time of surgery.Nineteen patients with palpable cancers underwent partial mastectomy after placement of surgical cues using patient-specific BCLs. The cues were in place in5 min and no adverse events occurred. The BCL accurately localized 18/19 cancers. In the 18 accurately localized cases, all 68 blue-dye injections were outside of the tumor edges. Median distance from the blue-dye center to the pathologic tumor edge was 1.4 cm, while distance from the blue dye to the tumor edge was5 mm in 4% of injections, 0.5-2.0 cm in 72% of injections, and2 cm in 24% of injections. Median distance from the tumor center to the BCL-localized wire and to the clip placed at the time of diagnosis was similar (0.49 vs. 0.73 cm) on specimen mammograms.Information on breast cancer location and shape derived from a supine MRI can be transferred safely and accurately to patients in the operating room using a 3D-printed form.
- Subjects :
- medicine.medical_specialty
Supine position
Breast surgery
medicine.medical_treatment
Breast Neoplasms
Mastectomy, Segmental
Article
03 medical and health sciences
Imaging, Three-Dimensional
0302 clinical medicine
Breast cancer
Surgical oncology
Supine Position
Carcinoma
medicine
Breast-conserving surgery
Humans
Neoplasm Invasiveness
030212 general & internal medicine
Neoplasm Staging
medicine.diagnostic_test
business.industry
Carcinoma, Ductal, Breast
Magnetic resonance imaging
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Surgery
Carcinoma, Intraductal, Noninfiltrating
Surgery, Computer-Assisted
Oncology
030220 oncology & carcinogenesis
Female
Radiology
business
Mastectomy
Follow-Up Studies
Subjects
Details
- ISSN :
- 15344681 and 10689265
- Volume :
- 24
- Database :
- OpenAIRE
- Journal :
- Annals of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....1e715d617ce629de2a84ac0ffc5885a8