Predictive value of 3D imaging to guide implant selection in immediate breast reconstruction

Yu, Monica; Mahoney, Mary-Helen; Soon, Gordon S; Pinchuk, Brian; Somogyi, Ron B.

doi:10.1016/j.jpra.2021.10.007

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…A 2022 article similarly found that VBS measurements were consistently lower than mastectomy weights determined intraoperatively, aligning with the data presented in this study. 27 Still, it only presented data from the VBS software, potentially limiting its clinical utility.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Surface Analysis for Preoperative Prediction of Breast Volume: A Validation Study

Stern

Plotsker

Rubenstein

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Few studies have examined whether preoperative three-dimensional surface imaging can accurately predict breast volume. Reliably predicting breast volume preoperatively can assist with breast reconstruction planning, patient education, and perioperative risk stratification. Methods: The authors conducted a review of patients who underwent mastectomy from 2020 to 2021 and included all patients who had preoperative VECTRA XT three-dimensional imaging. VECTRA Analysis Module (VAM) and VECTRA Body Sculptor (VBS) were used for volumetric analysis using standard anatomical breast borders. Breast weights were obtained intraoperatively. Predictive accuracy was defined as VAM estimates ±10% of mastectomy specimen weight or ±100 g of mastectomy weight. Results:The study included 179 patients (266 breasts). There was no significant difference (P = 0.22) between mean mastectomy weight of 620.8 ± 360.3 g and mean VAM estimate of 609.5 ± 361.9 g. Mean VBS estimate was 498.9 ± 337.6 g, which differed from mean mastectomy weight (P < 0.001). When defining predictive accuracy as ±100 g, 58.7% of VAM and 44.4% of VBS estimates were accurate. Body mass index, body surface area, and ptosis grade significantly affected VAM and VBS breast volume predictions. Conclusions: VAM is more accurate at predicting mastectomy weight than VBS, likely because of VAM's analysis of surface topography rather than discrete surface landmarks. Discrepancies between VECTRA estimates and mastectomy weight were likely attributable to differences between surgical mastectomy borders and breast borders used in volumetric analysis. Surgeons should consider the physical characteristics of patients when using three-dimensional imaging.

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Section: Discussionmentioning

confidence: 99%

Three-Dimensional Surface Analysis for Preoperative Prediction of Breast Volume: A Validation Study

Stern

Plotsker

Rubenstein

et al. 2023

Plastic &Amp; Reconstructive Surgery

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“…Several studies have been performed using 3D scanning to predict prosthetic size from preoperative breast volumetric measurements in immediate one-stage reconstructions [ 32 , 37 , 38 , 39 , 40 ]. Nonetheless, various factors such as breast asymmetries, tumor staging, oncologic resection and patient preferences make this determination difficult [ 39 , 40 ].…”

Section: Preoperative Applicationsmentioning

confidence: 99%

Three-Dimensional Printing in Breast Reconstruction: Current and Promising Applications

Mayer,

Coloccini,

Viñas

2024

JCM

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Three-dimensional (3D) printing is dramatically improving breast reconstruction by offering customized and precise interventions at various stages of the surgical process. In preoperative planning, 3D imaging techniques, such as computer-aided design, allow the creation of detailed breast models for surgical simulation, optimizing surgical outcomes and reducing complications. During surgery, 3D printing makes it possible to customize implants and precisely shape autologous tissue flaps with customized molds and scaffolds. This not only improves the aesthetic appearance, but also conforms to the patient’s natural anatomy. In addition, 3D printed scaffolds facilitate tissue engineering, potentially favoring the development and integration of autologous adipose tissue, thus avoiding implant-related complications. Postoperatively, 3D imaging allows an accurate assessment of breast volume and symmetry, which is crucial in assessing the success of reconstruction. The technology is also a key educational tool, enhancing surgeon training through realistic anatomical models and surgical simulations. As the field evolves, the integration of 3D printing with emerging technologies such as biodegradable materials and advanced imaging promises to further refine breast reconstruction techniques and outcomes. This study aims to explore the various applications of 3D printing in breast reconstruction, addressing current challenges and future opportunities.

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“…Determining the ideal breast size is important in postmastectomy breast reconstruction 1 . In implant breast reconstruction, tools like three‐dimensional imaging, magnetic resonance imaging, and machine learning are available to predict implant sizes 2–4 . The opportunity for patients to directly see and hold the implants may also help them with their decisions on breast size.…”

Section: Introductionmentioning

confidence: 99%

Analyzing mastectomy and reconstruction weight in immediate autologous breast reconstruction: A preliminary study

Kim,

Ali,

Graziano

et al. 2024

Journal of Surgical Oncology

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BackgroundThis study aims to explore the ideal breast size by assessing the relationship between mastectomy to free flap weight ratio and complications as well as patient‐reported outcomes in autologous breast reconstruction (ABR).MethodA retrospective review of patients undergoing bilateral immediate ABR with mastectomy and flap weights available was completed. Patients were divided into three groups based on the ratio of mastectomy to flap weights. The patients were grouped as “maintained” if the flap weight was within 10% of the mastectomy weight. Patients with a weight difference greater than 10% were used to declare “downsized” or “upsized.” Outcomes included complications and four domains of the BREAST‐Q at 1‐year postoperatively.ResultsThree hundred and fifty‐nine patients were included in the analysis, of which 112 were downsized, 91 maintained, and 156 upsized, respectively. Presence of complications did not significantly differ among the groups. At 1‐year postoperatively, Sexual Well‐being significantly differed (p = 0.033). Between preoperative and 1 year, patients who upsized experienced an improvement in Satisfaction with Breasts by 16 points (p < 0.001), while patients who downsized experienced a decline in Physical Well‐being of the Chest by 7 points (p = 0.016). Multivariable linear regression model showed that Sexual Well‐being was 13 points lower in the downsized cohort than in the maintained cohort (β = −13, 95% confidence interval: −21 to −5.4; p = 0.001).ConclusionAlthough complication rates do not significantly differ between the three cohorts, patients who downsize may have lower Sexual Well‐being postoperatively. Surgeons should consider our preliminary findings to counsel patients preoperatively about the predicted breast size and the impact of downsizing on sexual health.

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Predictive value of 3D imaging to guide implant selection in immediate breast reconstruction

Cited by 3 publications

References 19 publications

Three-Dimensional Surface Analysis for Preoperative Prediction of Breast Volume: A Validation Study

Three-Dimensional Surface Analysis for Preoperative Prediction of Breast Volume: A Validation Study

Three-Dimensional Printing in Breast Reconstruction: Current and Promising Applications

Analyzing mastectomy and reconstruction weight in immediate autologous breast reconstruction: A preliminary study

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