Principal Investigator

Mia K
Awardee Organization

University Of Texas At Austin
United States

Fiscal Year
Activity Code
Early Stage Investigator Grants (ESI)
Not Applicable
Project End Date

3-D modeling-based decision support for optimizing quality of life following breast reconstruction

Breast reconstruction is a central component of the breast cancer treatment process for many women. The purpose of breast reconstruction is to recreate a breast form that is satisfying to the patient, facilitating her psychosocial adjustment o living as a breast cancer survivor. Decisions about breast reconstruction can be difficult and overwhelming for many women due to the number of options available and conflicting values and preferences. The long-term goal of our research is to enhance the consultation process for women undergoing breast reconstruction surgery. Our vision is a decision support system that will enable breast cancer patients, in consultation with their healthcare providers, to choose a reconstruction strategy with maximal potential to optimize psychosocial adjustment. This system for shared decision-making will use quantitative models to tailor the presentation of patient-specific information about breast reconstruction outcomes. Three common features of decision support systems are the knowledge base; the methodology for combining that knowledge with patient-specific information; and the communication mechanisms. With recent NIH support, we established a unique knowledge base through a longitudinal study of 500 women who underwent breast reconstruction. We also developed preliminary computational models for combining that knowledge base with patient-specific data. Our models are parameterized by experimental, clinical, and psychosocial data and employ techniques from 3D image analysis, biomechanical modeling and simulation, machine learning, and decision analysis. In the proposed project, we will develop predictive algorithms for combining the knowledge base and patient- specific information, and we will develop communication mechanisms both for gathering necessary patient- specific information and for delivering information about the decision basis to the patient and her multidisciplinary care team.


  • Li D, Cheong A, Reece GP, Crosby MA, Fingeret MC, Merchant FA. Computation of breast ptosis from 3D surface scans of the female torso. Computers in biology and medicine. 2016 Nov 1;78:18-28. Epub 2016 Sep 9. PMID: 27643463
  • Nicklaus KM, Gonzalez XT, Sachdev K, Liu J, Chopra D, Hoffman AS, Hanson SE, Markey MK, Reece GP. What Does "Dr. Google" Show Patients Searching for Breast Reconstruction Outcomes Photographs? Plastic and reconstructive surgery. Global open. 2022 May 16;10(5):e4331. doi: 10.1097/GOX.0000000000004331. eCollection 2022 May. PMID: 35702539
  • Nicklaus KM, Wang H, Bordes MC, Zaharan A, Sampathkumar U, Cheong AL, Reece GP, Hanson SE, Merchant FA, Markey MK. Potential of Intraoperative 3D Photography and 3D Visualization in Breast Reconstruction. Plastic and reconstructive surgery. Global open. 2021 Oct 7;9(10):e3845. doi: 10.1097/GOX.0000000000003845. eCollection 2021 Oct. PMID: 34646718
  • Sampathkumar U, Nowroozilarki Z, Bordes MC, Reece GP, Hanson SE, Markey MK, Merchant FA. Review of Quantitative Imaging for Objective Assessment of Fat Grafting Outcomes in Breast Surgery. Aesthetic surgery journal. 2021 May 18;41(Suppl 1):S39-S49. PMID: 34002768
  • Nicklaus KM, Cheong A, Sampathkumar U, Liu J, Chopra D, Hoffman A, Merchant FA, Hanson SE, Markey MK, Reece GP. Breast Decisions: Recommender System for Appearance Counseling about Breast Reconstruction. Plastic and reconstructive surgery. Global open. 2022 Nov 3;10(11):e4615. doi: 10.1097/GOX.0000000000004615. eCollection 2022 Nov. PMID: 36348752
  • Reddy JP, Lei X, Huang SC, Nicklaus KM, Fingeret MC, Shaitelman SF, Hunt KK, Buchholz TA, Merchant F, Markey MK, Smith BD. Quantitative Assessment of Breast Cosmetic Outcome After Whole-Breast Irradiation. International journal of radiation oncology, biology, physics. 2017 Apr 1;97(5):894-902. Epub 2016 Dec 21. PMID: 28333010
  • Hoffman AS, Cantor SB, Fingeret MC, Housten AJ, Hanson SE, McGee JH, Pietz JT, Bennett A, Volk RJ, Reece GP. Considering Breast Reconstruction after Mastectomy: A Patient Decision Aid Video and Workbook. Plastic and reconstructive surgery. Global open. 2019 Nov 20;7(11):e2500. doi: 10.1097/GOX.0000000000002500. eCollection 2019 Nov. PMID: 31942296
  • Goodbrake C, Li DS, Aghakhani H, Contreras A, Reece GP, Markey MK, Sacks MS. On the Three-Dimensional Mechanical Behavior of Human Breast Tissue. Annals of biomedical engineering. 2022 May;50(5):601-613. Epub 2022 Mar 22. PMID: 35316441
  • Wang H, Liu J, Bordes MC, Chopra D, Reece GP, Markey MK, Hoffman AS. The role of psychosocial factors in patients' recollections of breast reconstruction options discussed with their surgeons. Scientific reports. 2022 May 6;12(1):7485. PMID: 35523931
  • Nicklaus KM, Liu YT, Liu C, Chu J, Jewett E, Bravo K, Bordes MC, Liu J, Reece GP, Hanson SE, Merchant F, Markey MK. Impact of implant-based breast reconstruction on bra fit. Ergonomics. 2022 Dec 26: 1-13. Epub 2022 Dec 26. PMID: 36524380
  • Teo I, Reece GP, Huang SC, Mahajan K, Andon J, Khanal P, Sun C, Nicklaus K, Merchant F, Markey MK, Fingeret MC. Body image dissatisfaction in patients undergoing breast reconstruction: Examining the roles of breast symmetry and appearance investment. Psycho-oncology. 2018 Mar;27(3):857-863. Epub 2017 Dec 19. PMID: 29152816
  • Nicklaus KM, Bui T, Bordes MC, Liu J, Chopra D, Hoffman AS, Reece GP, Hanson SE, Merchant FA, Markey MK. Goldilocks Principle: Preference for Change in Breast Size in Breast Cancer Reconstruction Patients. Frontiers in psychology. 2021 Sep 3;12:702816. doi: 10.3389/fpsyg.2021.702816. eCollection 2021. PMID: 34539505
  • Diab M, Kumaraswamy N, Reece GP, Hanson SE, Fingeret MC, Markey MK, Ravi-Chandar K. Characterization of human female breast and abdominal skin elasticity using a bulge test. Journal of the mechanical behavior of biomedical materials. 2020 Mar;103:103604. Epub 2019 Dec 26. PMID: 32090931
  • Kumaraswamy N, Khatam H, Reece GP, Fingeret MC, Markey MK, Ravi-Chandar K. Mechanical response of human female breast skin under uniaxial stretching. Journal of the mechanical behavior of biomedical materials. 2017 Oct;74:164-175. Epub 2017 May 19. PMID: 28599156
  • Nicklaus KM, Bravo K, Liu C, Chopra D, Reece GP, Hanson SE, Markey MK. Undergarment needs after breast cancer surgery: a key survivorship consideration. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2020 Aug;28(8):3481-3484. Epub 2020 Mar 25. PMID: 32215735
  • Sampathkumar U, Bui T, Liu J, Nowroolizarki Z, Bordes MC, Hanson SE, Reece GP, Markey MK, Merchant FA. Objective Analysis of Breast Symmetry in Female Patients Undergoing Breast Reconstruction After Total Mastectomy. Aesthetic surgery journal. Open forum. 2022 Dec 15;5:ojac090. doi: 10.1093/asjof/ojac090. eCollection 2023. PMID: 36654970
  • Chapman BV, Lei X, Patil P, Tripathi S, Nicklaus KM, Grossberg AJ, Shaitelman SF, Thompson AM, Hunt KK, Buchholz TA, Merchant F, Markey MK, Smith BD, Reddy JP. Quantitative 3-Dimensional Photographic Assessment of Breast Cosmesis After Whole Breast Irradiation for Early Stage Breast Cancer: A Secondary Analysis of a Randomized Clinical Trial. Advances in radiation oncology. 2020 May 21;5(5):824-833. doi: 10.1016/j.adro.2020.04.035. eCollection 2020 Sep-Oct. PMID: 33083644
  • Zhao L, Cheong A, Reece GP, Fingeret MC, Shah SK, Merchant FA. Inferior Breast-Chest Contour Detection in 3-D Images of the Female Torso. IEEE journal of translational engineering in health and medicine. 2016 Sep 29;4:4300410. doi: 10.1109/JTEHM.2016.2614518. eCollection 2016. PMID: 32519998
  • Cheong AL, Liu J, Reece GP, Nicklaus KM, Catherine Bordes M, Hanson SE, Markey MK, Merchant FA. Natural Breast Symmetry in Preoperative Breast Cancer Patients. Plastic and reconstructive surgery. Global open. 2019 Jul 26;7(7):e2297. doi: 10.1097/GOX.0000000000002297. eCollection 2019 Jul. PMID: 31942335

Clinical Trials

Study Name Clinical Trial ID
Patient-Specific Decision Aid System for Shared Decision Making About Breast Reconstruction NCT05130580