Clinical Scorecard: Utilizing Three-Dimensional Printing for Surgical Guidance in Breast-Conserving Procedures: A Comprehensive Review of Oncological and Aesthetic Results

At a Glance

Key Highlights

• 3DP-BSGs reduce positive margin rates compared to conventional localization methods, with rates ranging from 0% to 18.2%.
• 3DP-BSGs provide a non-invasive, radiation-free alternative to wire or radioactive seed localization, improving procedural efficiency.
• Early evidence suggests favorable oncologic outcomes and aesthetic results, though data are limited by heterogeneity and small sample sizes.

Guideline-Based Recommendations

Diagnosis

• Utilize supine MRI imaging to create patient-specific 3D printed surgical guides for tumor localization in breast-conserving surgery.

Management

• Incorporate 3DP-BSGs to assist in achieving negative surgical margins during breast-conserving treatment.
• Consider 3DP-BSG use especially in patients undergoing surgery after neoadjuvant chemotherapy to improve margin control.

Monitoring & Follow-up

• Assess margin status intraoperatively and postoperatively to evaluate effectiveness of 3DP-BSG guidance.
• Monitor recurrence rates longitudinally to compare with historical benchmarks.

Risks

• Recognize current evidence limitations including study heterogeneity and small sample sizes; larger randomized controlled trials are needed.
• Be aware that aesthetic outcomes and surgeon satisfaction data are inconsistently reported and require further validation.

Patient & Prescribing Data

1,126 patients across 14 studies, including 587 patients using 3DP-BSGs

3DP-BSG use is associated with lower positive margin and recurrence rates compared to conventional localization; it reduces reliance on intraoperative ultrasound or wire placement.

Clinical Best Practices

• Adopt supine MRI-based 3D printing techniques to fabricate individualized surgical guides for breast-conserving surgery.
• Use 3DP-BSGs to enhance surgical precision and potentially improve oncologic and aesthetic outcomes.
• Standardize outcome measures including margin status, recurrence, and aesthetic results in future studies to better define clinical utility.
• Encourage multidisciplinary collaboration to integrate 3DP technology into breast cancer surgical protocols.
• Prioritize conducting larger randomized controlled trials to validate early promising results.

References

• Global cancer statistics 2020: GLOBOCAN estimates
• Long-Term oncologic outcome of breast-Conserving treatment in patients with breast cancer with BRCA variants
• The current progress and critical analysis of three-dimensional scanning and three-dimensional printing applications in breast surgery
• World Health Organization Global health estimates: deaths by cause, age, sex, by country and by region, 2000–2019