Towards a Biomechanical Model of the Breast: A Simulation-Based Study
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AbstractThe clinical and financial impact of breast cancer on the U. S. health care system is great. In addition to the tangible metrics of costs and number of diagnoses, the psychological distress that accompanies a lump found in the breast is compounded by the apparent problems noted with contemporary reconstructive procedures. Currently, breast reconstruction is conducted largely by trial and error and varies with physician experience. For instance, a surgeon today will request three to four different sized implants for the operating room and will try each one, siting the patient up each time, until the desired volume and shape of the breast is achieved. The novel union of surgeons with machines and multi-modality information, made possible by advances in engineering and computing, has enormous potential in overcoming limitations realized with contemporary standard of care. For example, a virtual model of a patients breast will assist the surgeon in deciding a priori what implant size to order for the operating room such that desired breast outcomes are achieved. Our long-term goal is to develop novel computer-assisted surgical systems to significantly change breast cancer health care. Our approach builds upon four broad core areas of enabling knowledge and techniques, namely (1) multi-modality imaging, (2) simulation, (3) soft tissue biomechanics, and (4) interface subsystems. Recently, we developed a parametric deformable model of a female breasts shape that allows the surgeon to manipulate the shape of the breast by varying key shape variables, analogous to the aesthetic and structural elements surgeons inherently vary manually during breast reconstruction [2]. Such a system may enhance the practice of breast surgery at multiple points. It enables the patient to communicate her expectations more clearly to the surgeon. It allows the surgeon to educate the patient with more accurate explanations about what can be accomplished, and after the consultation, it helps the surgeon plan specific aspects of the procedure to achieve the agreed upon goals.
