For every daughter, mother, and sister of a breast cancer survivor, the trauma and fear of being diagnosed with cancer is palpable.
In the United States, one in eight women can expect to be faced with a breast cancer diagnosis within her lifetime, according to the National Breast Cancer Association.
In an effort to help breast cancer patients and survivors, HEALTH Research Institute’s Dr. Fatima Merchant has been developing 3D image analysis software for surgical planning and outcome assessment in breast reconstruction. Serving as a University of Houston (UH) professor of Engineering Technology in the UH College of Technology, Merchant was awarded a Small Business Technology Transfer (STTR) grant in the amount of $398,018 from NIH-NCI (National Cancer Institute).
This grant recognizes a collaboration between a small business, Soft Imaging, LLC, the University of Houston, and The University of Texas, MD Anderson Cancer Center (MDACC). Dr. Qiang Wu from Soft Imaging, LLC, and Dr. Gregory P. Reece from MDACC are co-investigators on the study.
“It’s about the quality of life for these women,” Merchant said. “Breast cancer survivors have beat cancer—but it’s important to think of the quality of life after cancer. Everyone is focused on curing cancer, but few are focused on what happens to these women once you’ve cured it.. They now have a second chance at life—let's give them the best quality of life possible.”
Through this grant, surgeons will be able to create 3D simulations of breast shape that are specifically tailored for women undergoing breast reconstruction surgery. Breast cancer patients considering reconstructive surgery will be able to view simulations of breast reconstruction outcomes based on their personal preferences, allowing them to make informed decisions when considering various surgical options.
“Our ultimate aim is to allow surgeons to interactively manipulate 3D simulations of breast shape when consulting women considering breast reconstruction. We can show women simulations of what their breasts may look like following surgery,” Merchant said. “They might say—yes, but you know, I would like my breast to be smaller in size, or the surgeon might see something different. We want to show women this simulation, so that they can communicate their preferences to their reconstructive surgeons.”
Merchant hopes that women will be empowered to make informed decisions and effectively communicate their reconstruction preferences in a way that gives them the most desirable body image through this research initiative.
This project is a collaboration with the Multidisciplinary Breast Reconstruction Research Program which houses a database of 3D images from 500 women who have undergone reconstructive surgery.
“Our team has taken 3D images of patients pre and postoperatively and as they undergo reconstructive surgery, at different times—baseline, and postoperatively at 3 months, 6 months, 9 months, 12 months and 18 months,” Merchant said.
The database information is then matched with women who are similar in appearance and medical histories to the patient undergoing consultation.
“When surgeons are consulting a new patient, we use algorithms to select images from our database that match the patient,” Merchant said. “These images can be used to inform our 3D simulations, and can also be shown to the new patient, who gets to see other women who’ve undergone reconstructive surgery and the changes that happened. This gives women some information on what can happen to them, which helps them make decisions and prepare for their reconstructive surgery.”
According to Merchant, one of the most challenging decisions women face right after being diagnosed with cancer is that they must quickly select the next steps for reconstruction. For women who just were told this devastating news, it’s critical to allow them to visualize how their breast shape can change based on the different reconstruction options so that they can make informed decisions and manage their expectations. This step is instrumental for the patients’ healing and recovery.
A milestone that’s been especially exciting for Merchant is the creation of an extensive library of imaging tools and algorithms which her research team has developed for this 3D breast imaging initiative.
“What we’ve done is build a number of 3D images analysis algorithms and modeling tools for quantitative analysis of breast appearance.”
Merchant hopes that her research initiative will help provide cancer patients and survivors with more information that will leave women an intrinsic satisfaction about their breast reconstruction options.
“We were able to outline how important this was for survival and the quality of life for women,” Merchant said. “We want to show women these simulations, so they might feel more comfortable, and they can communicate their preferences. What the surgeon can do might not match what the woman might want. Some women cannot express that, but if you can show them something, they can say, ‘Ok, this looks fine, but this is not what I would like to have.’ Or they can say, ‘Let me look at another option that I can do, and how can I change this.’ That is the tool that we’re working with.’”
Merchant emphasized that the 3D imaging research initiative has been a professionally and personally rewarding project for her and her students.
“This is really amazing,” Merchant said. “It is amazing because we have done several focus groups with patients who are very appreciative. I’ve also had students from my team who interact with patients. One of my Ph.D. students told me just last month, ‘Everybody only thinks how important it is to cure cancer. I came into this project with that attitude. Three years in, my perspective has changed and I'm so happy that I could work on something that will actually touch womens’ lives. It is very gratifying.’”
Dr. Merchant also serves as the Director of the Research Infrastructure Core in the HEALTH Center for Addictions Research and Cancer Prevention (NIMHD U54 RCMI; PI: Dr. Ezemenari M. Obasi).
By Alison Medley