3D-Printed Surgical Guides Are Helping Surgeons Save More Breast Tissue While Removing Tumors

For breast cancer patients with small tumors that haven’t spread to the lymph nodes and other parts of the body, a lumpectomy may be the best option for conserving as much breast tissue as possible while eradicating the cancer. And now surgeons may be able to save even more of their patients’ breast tissue with the help of some special 3D-printed guides.

When attempting to save as much breast tissue as possible, precision is key. If too little tissue is taken, not all of the cancer will be removed, and it will be very likely to start growing and spreading again. And in up to 58 percent of cases, conventional scans will underestimate the size of a patient’s tumor, making this scenario even more likely.

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Procedures such as Wire-Guided Localization (WGL) and Radioactive Seed Localization (RSL) approach have been invented to help surgeons cut more precisely, but there are risks to these technologies as well, such as accidentally cutting through tissue that wasn’t supposed to be cut, losing the wire inside the patient, or causing radiation-related side effects for the patient.

Up until now, the safest move has been to take more tissue than is really needed in order to make sure all the cancer has been removed. But those days may be over, thanks to this new innovation.

Researchers from the Korea-based Asan Medical Center created 3D-printed guides for surgeons to use to show them how much tissue to take away from the area surrounding the tumor during surgery. During their testing of 11 consenting individuals, they found that the guides could be customized for each individual patient and that it was safe for surgeons to take away as little as one centimeter of tissue around the tumor in order to ensure that all of the cancer was removed. That means more of the breast tissue can be conserved more safely than ever before.

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The 3D-printed guide is created following an MRI scan that determines where the patient’s tumor is and how it is shaped and positioned. Materialise’s Medical Software is used to print a perfect guide for every patient that surgeons can bring into the operating room to show them where to cut.

Each guide has a hole that goes around the patient’s nipple and a suprasternal notch, column, and grooves to mark the surrounding tissue and the tumor beneath. Blue dye can be injected through the device’s columns to indicate what tissue is to be removed. The resulting item looks a bit like a small white matrix or lattice of hexagonal shapes that covers part of the patient’s breast.

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“Hospitals have to use MRI to determine the scope of surgery, however, [current] methods cannot directly mark the extent of the cancer on the breast,” says Kim Nam-gook, who led the research. “The research is significant in that the accuracy of the team’s 3D printing surgery guide has been proven even in early breast cancer.”

Each guide is built with a 5-millimeter margin of error. The median margin of error for other existing methods is 11 millimeters, more than double that of the new surgical guides.

Despite the small sample size, the team believes their device has proven its ability to improve surgical accuracy regardless of the cancer’s stage of development. In the future, the team hopes to develop their technique so that tailor-made guides can be widely adopted in hospitals across the world.

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