Abstract
Nowadays, breast cancer has become the most common cancer amongst females. As long as breast is assumed to be a feminine symbol, any imposed deformation of surgical procedures can affect the patients' quality of life. However, using a planning tool which is based on parametric modeling, not only improves surgeons' skills in order to perform surgeries with better cosmetic outcomes, but also increases the interaction between surgeons and patients during the decision for necessary procedures. In the current research, a methodology of parametric modeling, called Free-Form Deformation (FFD) is studied. Finally, confirmed by a quantitative analysis, we proposed two simplified versions of FFD methodology to increase model similarity to input data and decrease required fitting time.

Abstract
Background and objective: Cosmetic outcome of breast cancer conservative treatment (BCCT) remains without a standard evaluation method. Subjective methods, in spite of their low reproducibility, continue to be the most frequently used. Objective methods, although more reproducible, seem unable to translate all the subtleties involved in cosmetic outcome. The breast cancer conservative treatment cosmetic results (BCCT. core) software was developed in 2007 to try to overcome these pitfalls. The software is a semi-automatic objective tool that evaluates asymmetry, color differences and scar visibility using patient's digital pictures. The purpose of this work is to review the use of the BCCT. core software since its availability in 2007 and to put forward future developments. Methods: All the online requests for BCCT. core use were registered from June 2007 to December 2014. For each request the department, city and country as well as user intention (clinical use/research or both) were questioned. A literature search was performed in Medline, Google Scholar and ISI Web of Knowledge for all publications using and citing "BCCT.core". Results: During this period 102 centers have requested the software essentially for clinical use. The BCCT. core software was used in 19 full published papers and in 29 conference abstracts. Conclusions: The BCCT. core is a user friendly semi-automatic method for the objective evaluation of BCCT. The number of online requests and publications have been steadily increasing turning this computer program into the most frequently used tool for the objective cosmetic evaluation of BCCT.

Abstract
Patient-specific surgical predictions of Breast Conserving Therapy, through mechano-biological simulations, could inform the shared decision making process between clinicians and patients by enabling the impact of different surgical options to be visualised. We present an overview of our processing workflow that integrates MR images and three dimensional optical surface scans into a personalised model. Utilising an interactively generated surgical plan, a multi-scale open source finite element solver is employed to simulate breast deformity based on interrelated physiological and biomechanical processes that occur post surgery. Our outcome predictions, based on the pre-surgical imaging, were validated by comparing the simulated outcome with follow-up surface scans of four patients acquired 6 to 12 months post-surgery. A mean absolute surface distance of 3.3mm between the follow-up scan and the simulation was obtained.

Abstract
Breast cancer is one of the most mediated malignant diseases, because of its high incidence and prevalence, but principally due to its physical and psychological invasiveness. The study of this disease using computer science tools resorts often to the image segmentation operation. Image segmentation, although having been extensively studied, is still an open problem. Shortest path algorithms are extensively used to tackle this problem. There are, however, applications where the starting and ending positions of the shortest path need to be constrained, defining a closed contour enclosing a previously detected seed. Mass and calcification segmentation in mammograms and areola segmentation in digital images are two particular examples of interest within the field of breast cancer research. Usually the closed contour computation is addressed by transforming the image into polar coordinates, where the closed contour is transformed into an open contour between two opposite margins. In this work, after illustrating some of the limitations of this approach, we show how to compute the closed contour in the original coordinate space. After defining a directed acyclic graph appropriate for this task, we address the main difficulty in operating in the original coordinate space. Since small paths collapsing in the seed point are naturally favored, we modulate the cost of the edges to counterbalance this bias. A thorough evaluation is conducted with datasets from the breast cancer field. The algorithm is shown to be fast and reliable and suffers no loss in resolution.

Abstract
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 accurate and robust for a wide number of patients. In addition, comparing with previous research, the procedure for detecting prominent points was automated. © 2013 © 2013 Taylor & Francis.

Abstract
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 conservation 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 evaluation of aesthetic results should be mandatory in any institution performing breast cancer treatment, contributing to the improvement of current strategies by enabling the identification of variables which have a significant impact on the final aesthetic 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 technologies used in the aesthetic evaluation of BCCT. The most relevant publications related to the mentioned topics are presented, critically analysed and put in chronological perspective. Current and future trends are also discussed.

Abstract