PICTURE · Patient Information Combined for the Assessment of Specific Surgical Outcomes in Breast cancer

Breast cancer is the most common cancer to affect women in Europe and has a lifetime risk of 1 in 9. It is an increasingly treatable disease, however, and 10-year survival now exceeds 80%. Thus many women will live for many years with the potentially disfiguring aesthetic consequences of their treatment. When a woman faces a breast cancer diagnosis, and surgery is proposed, two options are available: breast-conserving surgery or mastectomy. The decision as to which type of surgery to offer patients is totally subjective and based almost exclusively on the judgment and experience of the clinician. In breast-conserving surgery, approximately 30% of women receive a suboptimal or poor aesthetic outcome, however there is currently no standardised method of identifying these women.The PICTURE project aims to address this issue by providing objective tools to predict the aesthetic outcome of breast conserving surgery. Using a combination of 3D photography, together with routinely acquired radiological images (i.e. mammography, ultrasound and MRI, when available), we will develop techniques to biomechanically model the anatomy of the breast and the effect of surgical removal of cancerous tissue. These predictive tools will enable alternative surgical strategies to be explored and the consequences of the available options, with respect to the appearance of the breast, to be visualised. This will aid communication of the type of breast surgery recommended by the surgeon, to the patient, and will empower patients to take an active role in a shared decision making process. These tools will also enable the patient's aesthetic appearance after treatment to be objectively evaluated.