乳腺癌是全球最常见的癌症类型。随着存活率的提高，人们对长期治疗结果和患者生活质量的关注也越来越多。尽管对于早期乳腺癌，乳腺保留手术（BCS）是首选治疗策略，但预期的愈合和乳房变形（美容）结果在外科医生和患者之间在选择BCS和更积极的乳房切除手术之间的影响很大。不幸的是，由于组织修复过程的复杂性和患者间的显著差异，BCS后的手术结果很难预测。为了克服这一挑战，我们开发了一个预测性的计算机力学生物学模型，模拟BCS后的乳房愈合和变形过程。该耦合生化-生物力学模型包括多尺度的细胞和组织力学，包括胶原沉积和重塑、胶原依赖的细胞迁移和收缩力、组织塑性变形等。我们利用临床上已有的观察乳腺窝萎缩和实验性猪乳腺切除术的组织病理数据对模型进行了校准。通过高斯过程代理优化生化和生物力学参数，成功地将计算模型拟合到数据上。然后，将校准的模型应用于定义影响愈合和乳房变形结果的关键生物力学参数和关系。进一步评估包括乳腺窝与乳房体积的百分比和乳房组织构成在内的患者特征的变异性，以确定对乳腺窝萎缩和乳房美容结果的影响，并且模拟结果与以前报道的人体研究结果很吻合。所提议的模型有潜力帮助外科医生和患者制定和讨论个体化治疗方案，以实现更满意的术后结果和改善生活质量。Copyright © 2023 Elsevier Ltd.版权所有。

Breast cancer is the most commonly diagnosed cancer type worldwide. Given high survivorship, increased focus has been placed on long-term treatment outcomes and patient quality of life. While breast-conserving surgery (BCS) is the preferred treatment strategy for early-stage breast cancer, anticipated healing and breast deformation (cosmetic) outcomes weigh heavily on surgeon and patient selection between BCS and more aggressive mastectomy procedures. Unfortunately, surgical outcomes following BCS are difficult to predict, owing to the complexity of the tissue repair process and significant patient-to-patient variability. To overcome this challenge, we developed a predictive computational mechanobiological model that simulates breast healing and deformation following BCS. The coupled biochemical-biomechanical model incorporates multi-scale cell and tissue mechanics, including collagen deposition and remodeling, collagen-dependent cell migration and contractility, and tissue plastic deformation. Available human clinical data evaluating cavity contraction and histopathological data from an experimental porcine lumpectomy study were used for model calibration. The computational model was successfully fit to data by optimizing biochemical and mechanobiological parameters through Gaussian process surrogates. The calibrated model was then applied to define key mechanobiological parameters and relationships influencing healing and breast deformation outcomes. Variability in patient characteristics including cavity-to-breast volume percentage and breast composition were further evaluated to determine effects on cavity contraction and breast cosmetic outcomes, with simulation outcomes aligning well with previously reported human studies. The proposed model has the potential to assist surgeons and their patients in developing and discussing individualized treatment plans that lead to more satisfying post-surgical outcomes and improved quality of life.Copyright © 2023 Elsevier Ltd. All rights reserved.