This technology can be incorporated into surgical planning, patient and staff education or outcome assessment. 3D scanning is done using either laser scanning devices, structured light devices or stereophotogrammetry. Although it was developed for industrial purposes, it is increasingly applied in medicine 17, 18. However, its clinical efficiency to improve objective measurements is not known.ģD surface scanning utilizes point cloud coordinates to construct an image of an object in 3D space.
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With the advent of new technologies, such as 3D scanning and 3D printing, several authors have investigated its applicability to assess both breast shape and volume accurately. The most accurate method was MRI.Ĭurrently, the objective evaluation of breast shape and volume, in addition to anticipating and simulating surgical outcomes, remain a research problem.
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This is consistent with a review by Choppin and co-workers in which error quantification was used to determine the accuracy of breast volume assessment tools 16. However, MRI and 3D imaging devices were the most reliable. Despite their low accuracy, traditional devices such as measuring tapes, breast casts and Grossman-Rounder devices were cheaper and more accessible. The settings, feasibility, reliability and reproducibility of results were compared.
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Xi and colleagues reviewed 276 articles from 1970–2013 and classified breast assessment methods depending on whether volume, shape or surface area was measured 15. Illustration by Bruno Baldissara 14.Īlthough using MRI in breast assessment has many limitations including shape distortion, cost and clinical impracticality, it was reported as being both reliable and accurate in breast volume assessment. b Breast shape distortion as the patient lies down prone during MRI scan. Figure 1 illustrates the difference in breast shape relative to body posture.Ĭomparison between breast shape in different positionsĪ Breast shape as viewed in the normal sitting or standing position. Therefore, in addition to their cost and limited accessibility, they cannot be used in breast shape assessment as the distortion produced by posture might affect surgical outcomes. Although the breast shape is viewed normally in a standing or sitting position, most of the accurate imaging modalities such as CT or MRI are performed with the patient lying down in prone position. Breast shape also changes according to whether the patient is standing up or lying down in supine or prone positions. Several methods of assessment have been investigated however, these are often subjective, expensive, with limited accessibility, time consuming or simply inaccurate 6–13. This could be attributed to several factors such as the communication gap between the expectations of the patient and the opinion of the surgeon or the lack of objective methods of shape and volume evaluation and outcome simulation.īreast assessment is often done visually and depends on the skills and experience of the surgeon. In the UK, one in every four women was dissatisfied by her reconstructive surgery outcomes 5.
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Although these procedures are common, the rate of dissatisfaction is also high. Irrespective of its goal, there is an ongoing increase in the number of cosmetic and reconstructive surgeries performed worldwide 4. The goals of breast surgery are to reconstruct the breast following partial or complete resection (often due to breast cancer), to aesthetically enhance breast shape or to correct a congenital or developmental deformity. Conditions that disrupt the shape or symmetry of the breast may affect the individual's body image, quality-of-life scores, sexual functioning and psychological health 1–3.