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Modeling Breast Cancer in Human Breast Tissue using a Microphysiological System

Modeling Breast Cancer in Human Breast Tissue using a Microphysiological System

Published on: April 23, 2021

A simulation framework for modeling tumor control probability in breast conserving therapy.

Wei Chen¹, Kenneth Gilhuijs², Joep Stroom³

¹Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology

|April 22, 2014

Summary

Microscopic disease after breast cancer surgery significantly impacts recurrence risk. This study quantifies the relationship between remaining tumor cells, radiation dose, and tumor control probability (TCP) using a novel simulation framework.

Keywords:

Breast-conserving therapy Microscopic disease Monte-Carlo simulation Tumor control probability

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Area of Science:

Oncology
Radiation Oncology
Medical Physics

Background:

Microscopic disease (MSD) post-tumorectomy is a primary driver of local recurrence in breast conserving therapy (BCT).
Quantitative analysis of MSD and radiotherapy (RT) dose effects on tumor control probability (TCP) has been limited.
Understanding these factors is crucial for optimizing BCT outcomes.

Purpose of the Study:

To develop and utilize a simulation framework to quantitatively explore the relationship between tumor load, radiation dose, and TCP.
To model the impact of microscopic disease on local recurrence risk after breast surgery.
To establish a predictive model for tumor control in BCT.

Main Methods:

Modeled total disease load and microscopic spread using pathology data.
Simulated post-tumorectomy residual disease load.
Extended the Webb-Nahum TCP model with clonogenic cell fraction and fitted parameters to clinical trial data.

Main Results:

Histopathology grade strongly correlates with MSD cell quantity.
Average residual MSD post-surgery was 12.5%, with significant patient-to-patient variability (0-100%).
Optimal clonogenic cell fraction was 1 in 2.7*10^6 cells; mean radiosensitivity estimated at 0.067 Gy^-1.

Conclusions:

Established a quantitative relationship between radiation dose and TCP within a new simulation framework.
The model incorporates detailed disease load, surgery, and radiotherapy parameters.
Provides a foundation for personalized radiotherapy planning in BCT.