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This review evaluates the impact of three-dimensional printing on surgical precision and aesthetic results in breast-conserving treatments.

February 23, 2026Open Access

Three-dimensional printing-guided surgical localization in breast-conserving surgery: A systematic review of oncologic and aesthetic outcomes

Key Points

This review evaluates the impact of three-dimensional printing on surgical precision and aesthetic results in breast-conserving treatments.
Conducted a systematic review following PRISMA guidelines.
Performed a comprehensive search across multiple medical databases.
Included studies evaluating 3DP-BSGs in breast-conserving surgery.
Assessed outcomes such as margin status, recurrence, aesthetic results, and surgeon satisfaction.
14 studies involving 1,126 patients were reviewed.
Positive margin rates in the 3DP-BSG group ranged from 0% to 18.2%, lower than conventional methods.
Post-neoadjuvant chemotherapy patients showed lower recurrence rates compared to historical benchmarks.
Aesthetic outcomes demonstrated favorable trends; however, reporting was inconsistent.

Abstract

Breast-conserving treatment (BCT), comprising surgery followed by radiotherapy, is a standard approach for early-stage breast cancer. Achieving negative surgical margins while preserving aesthetic integrity remains a challenge. Three-dimensional printing (3DP) technologies offer new opportunities for surgical precision through patient-specific breast surgical guides (3DP-BSGs), yet their application in breast-conserving surgery (BCS) remains under investigation. This systematic review followed PRISMA guidelines. A comprehensive search was conducted in PubMed, Embase, Cochrane Library, Scopus, Web of Science, and CNKI from January 2015 to December 2025. Studies evaluating 3DP-BSG or advanced localization techniques in BCS were included. Outcomes assessed included margin status, recurrence, aesthetic results, procedural efficiency, and surgeon satisfaction. Fourteen studies involving 1,126 patients were included. Among the 587 patients in the 3DP-BSG group, positive margin rates ranged from 0% to 18.2%, which is generally lower than the historical rates achieved with conventional methods. Recurrence rates in post-neoadjuvant chemotherapy (NACT) patients were also lower than previously reported benchmarks. 3DP-BSGs, typically derived from supine MRI, provided accurate tumor localization and reduced reliance on intraoperative ultrasound or wire placement. Aesthetic outcomes and surgeon satisfaction were inconsistently reported but showed favorable trends. 3DP-BSG is a non-invasive, radiation-free alternative to traditional localization methods in BCS, with potential advantages in margin control and workflow efficiency, especially in post-NACT settings. While early results are encouraging, current evidence is limited by heterogeneity and small sample sizes. Larger randomized controlled trials with standardized aesthetic and oncologic endpoints are needed to confirm clinical utility and facilitate integration into standard breast cancer surgery protocols.

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