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Partial breast resection for multifocal lower quadrant breast tumour using virtual reality
  1. Enora Laas1,
  2. Mohamed El Beheiry2,3,
  3. Jean-Baptiste Masson2,3 and
  4. Caroline Malhaire4
  1. 1 Surgery Department, Institut Curie, Paris, France
  2. 2 Decision and Bayesian Computation, Neuroscience Department, CNRS UMR 3571, Institut Pasteur, Paris, France
  3. 3 Decision and Bayesian Computation, Computational Biology Department, CNRS USR 3756, Institut Pasteur, Paris, France
  4. 4 Medical Imaging Department, Institut Curie, Paris, France
  1. Correspondence to Mohamed El Beheiry; mohamed.el-beheiry{at}; Mr Jean-Baptiste Masson; jean-baptiste.masson{at}


Oncoplastic surgery allows an increase in the number of indications for conservative breast cancer treatments. However, uncertainty as to whether it can be performed still exists in certain situations such as with multicentric or multifocal lesions, even when the breast volume can accommodate it. With the aid of a virtual reality software, DIVA, allowing the precise visualisation of tumours and breast volumes based entirely on the patient’s MRI, we report the ability to rapidly confirm and secure an indication for partial surgery of multiple lesions in a 31-year-old patient. With the described approach, the patient did not have to suffer significant disfigurement from cancerous breast surgery without compromising safety.

  • breast surgery
  • breast cancer
  • radiology

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  • J-BM and CM are joint senior authors.

  • EL and MEB are joint first authors.

  • Twitter @MoElbeheiry

  • J-BM and CM contributed equally.

  • EL and MEB contributed equally.

  • Contributors EL, J-BM and MEB wrote the manuscript. MEB and J-BM developed the DIVA software. EL performed the surgery. CM prepared and analysed the images.

  • Funding Roche France provided financial support for the construction of the Institut Curie neoadjuvant database (NEOREP).

  • Disclaimer The funding source had no role in data analysis and interpretation or in the writing of the manuscript.

  • Competing interests MEB and J-BM are cofounders and shareholders and, respectively, Chief Technology Officer and Chief Scientific Officer of AVATAR MEDICAL SAS, a startup that commercialises software for surgery planning in virtual reality. The DIVA software used in this study is not being commercialised by AVATAR MEDICAL SAS but was based on the same technology. The DIVA software used in this study is freely available and is reported in El Beheiry M, et al, 'DIVA: Natural Navigation Inside 3D Images Using Virtual Reality', J Mol Biol. 432(16): 4745–9 (2020).

  • Provenance and peer review Not commissioned; externally peer reviewed.