3D Printing for Surgical Guidance in Breast-Conserving Procedures: Oncologic and Aesthetic Outcomes

Overview

This systematic review of 14 studies involving 1,126 patients evaluated the use of three-dimensional printed breast surgical guides (3DP-BSGs) in breast-conserving surgery (BCS). Findings suggest that 3DP-BSGs improve surgical margin control and reduce recurrence rates, particularly in post-neoadjuvant chemotherapy patients, while also enhancing procedural efficiency.

Background

Breast-conserving treatment (BCT), combining surgery and radiotherapy, is standard for early-stage breast cancer but balancing oncologic safety with aesthetic outcomes remains challenging. Traditional localization methods like wire-guided or radioactive seed localization have limitations including invasiveness and radiation exposure. Three-dimensional printing (3DP) technologies enable creation of patient-specific surgical guides derived from imaging such as supine MRI, potentially improving tumor localization and surgical precision. However, the clinical utility of 3DP-BSGs in BCS requires further validation through systematic evaluation.

Data Highlights

Key Findings

• 3DP-BSGs provide accurate tumor localization using supine MRI data, enhancing surgical precision.
• Positive surgical margin rates with 3DP-BSGs ranged from 0% to 18.2%, generally lower than conventional localization techniques.
• Recurrence rates in patients receiving neoadjuvant chemotherapy were reduced compared to historical controls.
• 3DP-BSGs reduce dependence on invasive or radiation-based localization methods such as wire placement or radioactive seeds.
• Aesthetic outcomes and surgeon satisfaction showed favorable trends but were inconsistently reported across studies.
• Evidence is limited by study heterogeneity and small sample sizes, underscoring the need for larger randomized controlled trials.

Clinical Implications

Three-dimensional printed breast surgical guides represent a promising non-invasive alternative to traditional localization methods in breast-conserving surgery, potentially improving margin negativity and reducing recurrence, especially in post-neoadjuvant chemotherapy patients. Their use may streamline surgical workflow by minimizing reliance on intraoperative ultrasound or wire localization. Clinicians should consider integrating 3DP-BSGs cautiously while awaiting further high-quality evidence.

Conclusion

3DP-BSG technology offers encouraging oncologic and procedural benefits in breast-conserving surgery, with potential to enhance both surgical precision and patient outcomes. Further large-scale, standardized studies are essential to confirm these advantages and support routine clinical adoption.

References

1. Alshehri SA et al. 2021 -- The current progress and critical analysis of three-dimensional scanning and three-dimensional printing applications in breast surgery
2. Lee J et al. 2025 -- Long-Term oncologic outcome of breast-Conserving treatment in patients with breast cancer with BRCA variants
3. Sung H et al. 2021 -- Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries