The Development of a Lifelike Breast Cancer Patient Simulator using Anthropometric Data

Background: Early detection significantly reduces breast cancer mortality. Yet, many medical students and doctors report they could improve their skills in clinical breast examination (CBE). Training programs using silicone breast simulators improve the lump detection rate. Despite this, medical students and trainees typically perform low in breast examination scores. This indicates current simulation models provide insufficient CBE training. In this study, we have improved breast examination simulators by applying anthropometric data and selecting one very commonly occurring shape in the female population as a model. Aims: To provide a breast model representative of the large size female population and more varied scenarios for breast lump palpation. Method: Comparing the 2002 National Size and Shape Survey of 1,250 adult Australian women, Australian Bureau of Statistics data, and the Civilian American and European Surface Anthropometry Resource Project (CAESAR®), we selected individuals anthropometrically representative of the surveyed population. Combining one woman’s body scan, computer-aided design, rapid prototype techniques, and the latest biofidelic (lifelike) silicone technology we created an anatomically correct representation of a real world patient. This model requires trainees to learn that breast examination can be complex and involves a multifaceted approach. Results: A prototype representing women with larger breast size and a relatively high body mass index (BMI) was developed. The individual selected was a large size woman of approximate BMI 30, 82kg and large cup size (D); by our analysis more than 50% of women are C cup or above. Conclusions: Confident and competent breast palpation requires a life-size model that looks and feels lifelike. Currently available breast examination simulators do not model the size and shape of patients encountered. This impedes developing confidence and competence in health care workers who need these skills. Lifelike look and feel require an anatomically correct, multi-layered soft breast construction, incorporating palpable anatomical underlying features, including tumors.