Modeling of the Type of Surgical Intervention for Breast Cancer According to Mammography Examination: Analysis of Factors

Abstract

Breast cancer is the most common tumour diagnosis for women worldwide. Over the last 40 years widespread adoption of mammographic screening has established Breast Conserving Surgery (BCS) followed by irradiation as the most practised treatment of choice. However, given the absence of tools to determine the optimal volume of tissue to be excised, the debate continues for achieving a balance between the effectiveness of surgical intervention and the later stage personalization of treatment, and so, a wide variation in practice is a common phenomenon globally. This study is devoted to modeling and analysis of factors which affect the choice of type and volume of surgical intervention for patients with breast cancer in not at random manner. Given the problems of treating patients with breast cancer, it is extremely important to determine the criteria for an objective choice of the type of surgical intervention at the diagnostic stage. These criteria should ensure both the radical nature of the surgical intervention and the preservation of aesthetically acceptable forms and sizes of the mammary glands. The study included 73 patients with breast cancer who underwent a mammographic examination and surgery planned according to this examination. The planned type and volume of interventions were compared with the type and volume of the performed ones. Based on the simulation results, the leading mammographic factors were determined. A statistical model allowing one to quite effectively determine optimal type and volume of surgical intervention based on the data of a mammographic examination and the lesion coefficient as the covariates was built. The proposed model considers the characteristics of the tumor and the anatomical features of patients which, in addition to providing real-time information, enables for predicting the optimal type and amount of surgical intervention. An adequate choice of type of the intervention allows one to plan short-term reconstructive measures in advance, to ensure an adequate quality of life for patients after treatment.