Numerical models for breast surgery and reconstruction

This chapter summarizes image analysis and biomechanical modeling of the breast that has been directed to applications in surgery and, in particular, oncoplastic surgical planning. A key component of such applications is the ability to model deformation of the breast between the patient standing, with the breast unsupported, and lying prone, for MR imaging, and lying supine, for surgery. We summarize the state-of-the-art and describe our approach to computing the unloaded (gravity free) configuration of the breast from prone and supine MR or CT images and how we use that to compute the transformation from prone to supine to standing positions. We also outline our approach to estimating the impact of oncoplastic surgery and surgical recovery on breast shape.