Acceptability of 3D‐printed breast models and their impact on the decisional conflict of breast cancer patients: A feasibility study

Abstract

Purpose To evaluate the acceptability and impact of 3D‐printed breast models (3D‐BMs) on treatment‐related decisional conflict (DC) of breast cancer patients. Methods Patients with breast cancer were accrued in a prospective institutional review board‐approved trial. All patients underwent contrast‐enhanced breast magnetic resonance imaging (MRI). A personalized 3D‐BM was derived from MRI. DC was evaluated pre‐ and post‐3D‐BM review. 3D‐BM acceptability was assessed post‐3D‐BM review. Results DC surveys before and after 3D‐BM review and 3D‐BM acceptability surveys were completed by 25 patients. 3D‐BM were generated in two patients with bilateral breast cancer. The mean patient age was 48.8 years (28−72). The tumor stage was Tis (7), 1 (8), 2 (8), and 3 (4). The nodal staging was 0 (19), 1 (7), and 3 (1). Tumors were unifocal (15), multifocal (8), or multicentric (4). Patients underwent mastectomy (13) and segmental mastectomy (14) with (20) or without (7) oncoplastic intervention. Neoadjuvant therapy was given to seven patients. Patients rated the acceptability of the 3D‐BM as good/excellent in understanding their condition (24/24), understanding disease size (25/25), 3D‐BM detail (22/25), understanding their surgical options (24/25), encouraging to ask questions (23/25), 3D‐BM size (24/25), and impartial to surgical options (17/24). There was a significant reduction in the overall DC post‐3D‐BM review, indicating patients became more assured of their treatment choice (p = 0.002). Reduction post‐3D‐BM review was also observed in the uncertainty (p = 0.012), feeling informed about options (p = 0.005), clarity about values (p = 0.032), and effective (p = 0.002) Decisional Conflict Scale subscales. Conclusions 3D‐BMs are an acceptable tool to decrease DC in breast cancer patients.

3D printed model for triple negative inflammatory breast cancer

“…To the authors’ knowledge, this technique has not been published for 3D printed breast tumor models. Studies by Santiago et al and Galstyan et al described techniques of 3D printed breast models segmented from contrast-enhanced breast magnetic resonance imaging (MRI) [ 2 , 7 , 8 ]. The interactive 3D printed model can help overcome potential educational, language and cultural barriers to improve one’s knowledge about their condition and enhance the quality of their decision making.…”

“…Utilization of 3D printing in medicine is increasing, and the potential positive clinical implications and interest continue to gain momentum. Numerous applications are demonstrated using 3D printing in breast cancer management including improved understanding of the disease for the patient and the healthcare team reducing treatment decision conflict especially between mastectomy and breast conserving surgery, aid in surgical planning, and intraoperative guidance to optimize the oncological and aesthetic outcomes [ 2 , 7 , 8 ]. Furthermore, 3D printed breast models can be used to facilitate medical education for multidisciplinary trainees from radiology to surgery, oncology, and pathology.…”

Radiological Society of North America (RSNA) 3D Printing Special Interest Group (SIG) clinical situations for which 3D printing is considered an appropriate representation or extension of data contained in a medical imaging examination: Breast Conditions

“…Understanding the extent of disease at the time of diagnosis allows appropriate staging and determination of prognosis and survival in addition to selection of suitable surgical options 14 . They are also an effective tool to reduce decision con ict in patients and enhance the informed consent 15 . 3D printed models have the ability of depicting the extent of disease and relationships of sensitive anatomy 16 .…”

“…PubMed Search: ((3D printing) AND (breast cancer) OR ((rapid prototyping) AND (breast cancer))PubMed Results: 1415,16,[18][19][20][21][22][23][24][25][26][27][28][29] a. Schulz-Wendtland R, Harz M, Meier-Meitinger M, et al Semi-automated delineation of breast cancer tumors and subsequent materialization using three-dimensional printing (rapid prototyping). J Surg Oncol.…”

3D-Printed Replica and Porcine Explants for Pre-Clinical Optimization of Endoscopic Tumor Treatment by Magnetic Targeting

“…With these replicas, they proved that patients could better understand their individual conditions. Similarly, Santiago et al were able to prove that 3D breast models were a good tool to decrease the decisional conflict in patients with breast cancer [13]. Kong et al developed several 3D-printed replicas of hepatic segments from CT scans as a teaching aid for young surgeons [5].…”