André Magalhães

An accurate and interpretable model for BCCT.core

Breast Cancer Conservative Treatment (BCCT) is considered nowadays to be the most widespread form of locor-regional breast cancer treatment. However, aesthetic results are heterogeneous and difficult to evaluate in a standardized way. The limited reproducibility of subjective aesthetic evaluation in BCCT motivated the research towards objective methods. A recent computer system (BCCT.core) was developed to objectively and automatically evaluate the aesthetic result of BCCT. The system is centered on a support vector machine (SVM) classifier with a radial basis function (RBF) used to predict the overall cosmetic result from features computed on a digital photograph of the patient. However, this classifier is not ideal for the interpretation of the factors being used in the prediction. Therefore, an often suggested improvement is the interpretability of the model being used to assess the overall aesthetic result. In the current work we investigate the accuracy of different interpretable methods against the model currently deployed in the BCCT.core software. We compare the performance of decision trees and linear classifiers with the RBF SVM currently in BCCT.core. In the experimental study, these interpretable models shown a similar accuracy to the currently used RBF SVM, suggesting that the later can be replaced without sacrificing the performance of the BCCT.core.

Methods for the Aesthetic Evaluation of Breast Cancer Conservation Treatment: A Technological Review

Breast-conserving approaches aim to attain better aesthetic results in addition to local control and achieving survival rates equivalent to mastectomy in patients with breast cancer. While the oncologic outcome of breast conserva- tion procedures is easily estimated objectively by disease-free and overall survival rates, the cosmetic outcome has no standard of evaluation. Although breast conservation techniques have been widely studied, different forms of evaluation and heterogeneous working practices have contributed to different aesthetic results. As this scenario suggests, the evalua- tion of aesthetic results should be mandatory in any institution performing breast cancer treatment, contributing to the im- provement of current strategies by enabling the identification of variables which have a significant impact on the final aes- thetic result. In the process of assessing cosmetic outcomes there are several important issues that should be considered: which factors have a crucial impact on the cosmetic outcome of Breast Cancer Conservation Treatment (BCCT); which parameters or features should be evaluated in the cosmetic assessment of BCCT; how patients are evaluated; which scales are used in this evaluation; which methods and technological solutions are available for the evaluation of cosmetic results of BCCT. In this paper we try to discuss all these questions, with an emphasis on the objective methods and corresponding tech- nologies used in the aesthetic evaluation of BCCT. The most relevant publications related to the mentioned topics are pre- sented, critically analysed and put in chronological perspective. Current and future trends are also discussed.

Is face-only photographic view enough for the aesthetic evaluation of breast cancer conservative treatment?

The breast cancer conservative treatment. cosmetic results (BCCT.core) is a new software tool created for the automatic and objective evaluation of the aesthetic result of BCCT. It makes use of a face-only photographic view of each patient and might thus have been considered insufficient for an accurate evaluation, as others have used multiple views of each patient. The purpose of this work is to compare the performance of the BCCT.core (using face-only views) with a subjective expert analysis using both the face-only and four-view assessment. Photographs in four-views of 150xa0patients, were evaluated by a panel of experts and a consensus classification was obtained. The agreement between the consensus and the BCCT.core (face-only view) was calculated using the kappa (k) and weighted kappa (wk) statistics. Face-only views, of the same 150xa0patients, were subsequently sorted out in a different order and sent for individual evaluation by three specialists from the previous panel of experts. The individual agreement between the face-only view and the four-view evaluation by each of the three experts and the consensus was calculated using the same methods. Obtained results were compared to the BCCT.core performance. The software obtained a moderate agreement with the consensus (kxa0=xa00.57; wkxa0=xa00.68). The highest value of agreement, from the three experts, between the four-view evaluation and the consensus was identical to the software agreement (kxa0=xa00.55; wkxa0=xa00.67). In the face-only view experiment, the highest value of agreement between the experts and the consensus was only fair (kxa0=xa00.37; wkxa0=xa00.54). Performance of the software was thus considered equal to that obtained by experts using a four-view evaluation.

A 3D low-cost solution for the aesthetic evaluation of breast cancer conservative treatment

Breast cancer conservative treatment (BCCT) is now the preferred technique for breast cancer treatment. The limited reproducibility of standard aesthetic evaluation methods led to the development of objective methods, such as the software tool Breast Cancer Conservative Treatment.cosmetic results (BCCT.core). Although results are satisfying, there are still limitations concerning complete automation and the inability to measure volumetric information. With the fundamental premise of maintaining the system a low-cost tool, this work studies the incorporation of the Microsoft Kinect sensor in BCCT evaluations. The aim is to enable the automatic joint detection of prominent points, both on depth and RGB images. Afterwards, using those prominent points, it is possible to obtain two-dimensional and volumetric features. Finally, the aesthetic result is achieved using machine learning techniques converted automatically from the set of measures defined. Experimental results show that the proposed algorithm is acc...

Simultaneous detection of prominent points on breast cancer conservative treatment images

Breast Cancer Conservative Treatment (BCCT) is now the preferred technique for breast cancer treatment. The limited reproducibility of standard aesthetic evaluation methods led to the development of objective methods, such as Breast Cancer Conservative Treatment.cosmetic results (BCCT.core) software tool. Although the satisfying results, there are still limitations concerning complete automation and the inability to measure volumetric information. With the fundamental premise of maintaining the system as a low-cost tool, the incorporation of the Microsoft Kinect sensor in BCCT evaluations was studied. The aim with this work is to enable the simultaneous detection of breast contour and breast peak points using depth-map data. Experimental results show that the proposed algorithm is accurate and robust for a wide number of patients. Additionally, comparatively to previous research, the procedure for detecting prominent points was automated.

Is Kinect Depth Data Accurate for the Aesthetic Evaluation after Breast Cancer Surgeries

The conservative treatment is now the preferred procedure to treat breast cancer mainly due to better aesthetical results obtained. However, the aesthetic outcome is diverse and very difficult to evaluate, which motivates the research on automatic methodologies. The use of three-dimensional (3D) methodologies is increasing; however, the high cost of the equipment and the need for specialised technicians to operate it are import setbacks. Consequently, the search for affordable and easy to perform equipments is highly desirable. This paper studies the application of a Kinect device in this field, addressing issues related to accuracy, resolution and quality of the data. The paper demonstrates a comparative study of state-of-the-art Super-Resolution (SR) algorithms applied to the Kinect depth data, and the importance to improve the quality of images is stressed. The results demonstrate that it is possible to measure volumetric information and that there is agreement between features and the subjective aesthetic evaluation.

Improving the BCCT.core model with lateral information

Breast Cancer Conservative Treatment (BCCT) is considered the gold standard of breast cancer treatment. However, the aesthetic outcome is diverse and very difficult to evaluate in a consistent way partly due to the weak reproducibility of the subjective methods in use. This motivated the research on the objective methods. BCCT.core is a very recent software that objectively and automatically evaluates the aesthetic outcome of BCCT. However, as in other approaches, the system only uses frontal patient information, disregarding volumetric perception on lateral measurements. In the current work we investigate the improvement of the BCCT.core model by introducing lateral information extracted from patients images. We compare the performance of the model currently used on BCCT.core with the model developed in this study. Experimental results suggest that with lateral measurements the model presents better performance, however improvements are not significant. We can conclude that is essential to use robust models on the BCCT, and the input of 3D models will probably help to obtain better results.

A Kinect-Based System to Assess Lymphedema Impairments in Breast Cancer Patients

Common breast cancer treatments, as the removal of axillary lymph nodes, cause severe impairments in women’s upper-body function. As a result, several daily activities are affected which contributes to a decreased QOL. Thus, the assessment of functional restrictions after treatment is essential to avoid further complications. This paper presents a pioneer work, which aims to develop an upper-body function evaluation method, traduced by the identification of lymphedema. Using the Kinect, features of the upper-limbs motion are extracted and supervised learning algorithms are used to construct a predictive classification model. Very promising results are obtained, with high classification accuracy.

A Kinect-Based System for Upper-Body Function Assessment in Breast Cancer Patients

Common breast cancer treatment techniques, such as radiation therapy or the surgical removal of the axillary lymphatic nodes, result in several impairments in women’s upper-body function. These impairments include restricted shoulder mobility and arm swelling. As a consequence, several daily life activities are affected, which contribute to a decreased quality of life (QOL). Therefore, it is of extreme importance to assess the functional restrictions caused by cancer treatment, in order to evaluate the quality of procedures and to avoid further complications. Although the research in this field is still very limited and the methods currently available suffer from a lack of objectivity, this highlights the relevance of the pioneer work presented in this paper, which aims to develop an effective method for the evaluation of the upper-body function, suitable for breast cancer patients. For this purpose, the use of both depth and skeleton data, provided by the Microsoft Kinect, is investigated to extract features of the upper-limbs motion. Supervised classification algorithms are used to construct a predictive model of classification, and very promising results are obtained, with high classification accuracy.

Neoadjuvant endocrine therapy in breast cancer patients

HighlightsThe overall response rate to neoadjuvant endocrine therapy (NET) was 54.55%.The eight patients proposed to tumours downstage, after 9.71 months of NET, preserved their breast.In the group which achieved response, 10.28 months was the mean time to accomplish it.Even patients who had the worst outcome only began to suffer latter in the course of therapy.NET can be done beyond the conventional 3–4 months to allow additional downstage of the tumour. Background The aim of this study is to evaluate if the extension of neoadjuvant endocrine therapy (NET), beyond the conventional time, allows additional downstage of the tumour, in order to perform a breast conservative surgery (BCS), and to analyze if it is a good option for long‐term control in patients who refuse or are unfit for surgery. Patients and methods We retrospectively reviewed a database containing all patients treated in our institution with NET. All included patients were post‐menopausal with primary local disease. The type of response obtained was assessed using modified RECIST criteria. Results Thirty‐three patients were included. Two patients had tumours with 90% expression of oestrogen receptors and all the others had 100%. The tumour size in the largest diameter was 6.51 cm before treatment and 5.18 cm after. Eighteen patients achieved a partial response after 10.28 months of therapy. Patients that were proposed to downstage the tumour performed 9.71 months of therapy until surgery and all were submitted to BCS. Progression occurred after 27.5 months. Conclusion Endocrine therapy is a feasible option for a longer time to allow additional downstage of the tumour and is a good solution in patients who refuse or are unfit for surgery.