Eligibility of patients for minimally invasive breast cancer therapy based on MRI analysis of tumor proximity to skin and pectoral muscle |
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Authors: | Laura G Merckel MD PhD Erik Verburg MSc Bas HM van der Velden MSc Claudette E Loo MD PhD Maurice AAJ van den Bosch MD PhD Kenneth GA Gilhuijs Msc PhD |
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Institution: | 1. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands;2. Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands;3. MIRA – Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands;4. Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands |
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Abstract: | There is growing interest in minimally invasive breast cancer therapy. Eligibility of patients is, however, dependent on several factors related to the tumor and treatment technology. The aim of this study is to assess the proportion of patients eligible for minimally invasive breast cancer therapy for different safety and treatment margins based on breast tumor location. Patients with invasive ductal cancer were selected from the MARGINS cohort. Semiautomatic segmentation of tumor, skin, and pectoral muscle was performed in Magnetic Resonance images. Shortest distances of tumors to critical organs (ie, skin and pectoral muscle) were calculated. Proportions of eligible patients were determined for different safety and treatment margins. Three‐hundred‐forty‐eight patients with 351 tumors were included. If a 10 mm safety margin to skin and pectoral muscle is required without treatment margin, 72.3% of patients would be eligible for minimally invasive treatment. This proportion decreases to 45.9% for an additional treatment margin of 5 mm. Shortest distances between tumors and critical organs are larger in older patients and in patients with less aggressive tumor subtypes. If a 10 mm safety margin to skin and pectoral muscle is required, more than two‐thirds of patients would be eligible for minimally invasive breast cancer therapy. |
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Keywords: | breast cancer magnetic resonance imaging minimally invasive therapy segmentation tumor location |
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