Kim Ah Yoon, Lee Sae Byul, Yoo Tae Kyung, Kim Ji Sun, Chung Il Yong, Kim Hee Joung, Lee Jong Won, Son Byung Ho, Jeong Jae Ho, Lee Hee Jin, Kim Nam Kug, Ko BeomSeok
Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Sci Rep. 2025 Jan 2;15(1):86. doi: 10.1038/s41598-024-82968-6.
In breast-conserving surgery (BCS), clear resection margins are crucial to prevent recurrence. Accurate imaging is vital for precise BCS, with MRI being the most accurate. However, MRI has limitations in identifying the exact extent of breast cancer in patients who have undergone neoadjuvant chemotherapy (NACT). A 3D-Printed Breast Surgical Guide (3DP-BSG) can address this issue by effectively pinpointing cancer extent in NACT patients, thus enhancing surgical accuracy. This retrospective single-institution cohort study focused on female patients diagnosed with invasive breast cancer who underwent NACT. Between November 2015 and October 2021, patients received BCS with the aid of a 3DP-BSG. Personalized 3DP-BSG targeted tumors by tracking changes in breast and tumor anatomy on MRI before and after NACT. 203 patients with invasive breast cancer were enrolled in the study. According to exclusion criteria, 197 patients were analyzed. The median follow-up period was 35.3 months (range: 2.2-96.8 months). 3 patients (1.5%) had positive resection margins. During the follow-up period, 17 patients (8.6%) experienced recurrence, with one patient (0.5%) confirmed local recurrences. The application of MRI-based 3DP-BSG is effective in achieving low positive margins and local recurrence in patients undergoing BCS after NACT, offering a promising approach for improving surgical outcomes.
在保乳手术（BCS）中，切缘阴性对于预防复发至关重要。精确的影像学检查对于精准的保乳手术至关重要，其中MRI最为准确。然而，MRI在识别接受新辅助化疗（NACT）的患者中乳腺癌的确切范围方面存在局限性。三维打印乳腺手术导板（3DP-BSG）可以通过有效确定NACT患者的癌症范围来解决这一问题，从而提高手术准确性。这项回顾性单机构队列研究聚焦于被诊断为浸润性乳腺癌并接受NACT的女性患者。在2015年11月至2021年10月期间，患者在3DP-BSG的辅助下接受了保乳手术。个性化的3DP-BSG通过追踪NACT前后MRI上乳房和肿瘤解剖结构的变化来靶向肿瘤。203例浸润性乳腺癌患者纳入研究。根据排除标准，对197例患者进行了分析。中位随访期为35.3个月（范围：2.2 - 96.8个月）。3例患者（1.5%）切缘阳性。在随访期间，17例患者（8.6%）出现复发，1例患者（0.5%）确诊为局部复发。基于MRI的3DP-BSG的应用对于接受NACT后进行保乳手术的患者实现低切缘阳性率和局部复发率是有效的，为改善手术结果提供了一种有前景的方法。
