Suitability of 3D scanning as a screening tool for reduction mammoplasty referrals for plastic surgery-a pilot study

Reduction mammoplasty is a common procedure in plastic surgery. However, patients need to fulfill resection weight criterion in order to get state or insurance coverage for the procedure. General practitioners in health centers might not have large experience for evaluating the breast size and this could lead to inadequate referrals. These referrals lead to expenses and use of limited health care resources. For this reason, the accurate estimation of breast size and resection weight is important. The conventional methods have inherent limitations in accurately capturing volumetric details and there is an urge to a shift towards more precise methods. There are many different three-dimensional (3D) imaging devices commercially available and used also for this purpose. The goal of our study was to evaluate if a handheld easy-to-use 3D scanner would be usable as an assistive device for general practitioners in the breast size evaluation to avoid unnecessary referrals. The aim of the current study was not to validate a 3D scanner.

The study population comprised 50 women recruited for the study in Tampere University Hospital, Finland. Of these patients 25 were recruited from the gynecological and 25 from the plastic surgery outpatient clinic. Patients had mammography imaging and 3D scanning performed to calculate breast volumes. The results were compared and statistical analyses were performed.

We found that 3D scanning correlated with mammography in patients with smaller breasts, but it gave systematically 300 cc smaller volumes than volumes obtained from mammograms. This phenomenon is most likely related to difficulties in cropping the breast and defining the border between the thoracic wall and breast.

In conclusion, with this study population of 50 patients we established that as it stands the handheld 3D scanning device has sufficient technical properties for breast scanning. However, the underestimation of volume in a described quantity is not acceptable and could lead to incorrectly rejected referrals. The need for standardized positioning of the patients and need for more comprehensive training for the use of the 3D scanner becomes apparent before its use in screening in daily general practice.