TissueDB/Tissues/Breast
Breast — also called mammary tissue — is composed of glandular epithelium, adipose tissue, and connective tissue stroma. The breasts are paired, and the distribution and density of glandular tissue relative to adipose tissue varies between individuals. In simulation the breast is almost always the BACKGROUND rather than the target: the published low-cost models here are built to teach ultrasound screening, ultrasound-guided core-needle biopsy and radio-guided localisation, and what they reproduce is a field of tissue with a findable lesion in it, not the anatomy of the breast itself.[1][2]
Materials
| Material | Visual | Tactile | Simulator | Notes |
|---|---|---|---|---|
| Agar (agar-agar), coloured with black ink, with green olives as the lesions | An in-house-designed training phantom which the authors describe as a "round pie" of black ink coloured agar–agar gel with several green olives floating inside, mimicking breast lesions. Undergraduates used it for ultrasound-guided core-needle biopsy with a BARD MAGNUM biopsy system under Hitachi Preirus and Hitachi Ascendus scanners; "presence of olive material inside the biopsy needle confirmed a correct biopsy", so the model reports its own hit. The authors give the cost as "approx. 2 Euros per phantom" — roughly US$2 — and chose it to avoid needing fresh cadavers or fleshy tissue such as turkey breast.[1] | |||
| Pimento olive and a green pea, in a turkey breast | A radio-guided localisation (RGL) phantom "imitating an occult breast lesion", built from inexpensive supplies "including a pimento olive, a green pea and a turkey breast". The abstract states a total cost of less than US$20 and preparation in approximately 10 minutes, and that about 25 further models were built to show the design was easily reproducible. Only the abstract of this paper is openly available, so nothing beyond these figures is stated here.[2] |
Things to Look Out For
Do not present the phantom as a breast. The authors of the agar-and-olives model put it first in their own list of limitations: "The training phantom made of agar–agar does not realistically resemble the human breast". It is a field with findable lesions in it. Anatomy, density variation and the tissue planes a real examination crosses are all absent.[1]
One session per phantom. The same limitation list records that "The phantom can only be used for one training session". So does the ex-vivo alternative it was chosen over. Budget one build per cohort, not one per course.[1]
The teaching cost is the staff, not the gel. The third limitation the authors record is that the training program "required a large time commitment from the teaching personal, and because of staff and budget constraints in many hospitals, might not yet be feasible in the routine setting". Roughly two euros of agar buys the target; it does not buy the teaching time the result depended on, and the trainers were "experienced breast specialists and ultrasound examiners".[1]
- Tumor — the lesion the breast models exist to teach the finding of; Breast Lesions redirects there
- Skin — surface layer covering breast
- Adipose Tissue — major breast component
- Connective Tissue — supporting stromal matrix
- Subcutaneous Tissue — tissue beneath skin
Simulation Requirements
| Domain | Requirements |
|---|---|
| Visual | Ultrasound, not eyesight. The requirement is a background quiet enough on ultrasound for a lesion to stand out and take a needle under live imaging — the published phantom is black-ink coloured agar–agar with green olives floating in it, and the paper shows that phantom imaged "Before" and "After core needle biopsy". The model is not required to look like a breast from the outside, and its authors record that it does not.[1] |
| Tactile | Not characterised in either source held here. The Schmidt paper reports no firmness, indentation or palpation measurement for the breast-tissue background and sets no tactile fidelity target for it; the Aydogan abstract, the only part openly available, reports none either. In both models the lesion is found by imaging rather than by hand — in the agar phantom a correct biopsy is confirmed by "presence of olive material inside the biopsy needle", and the lesion the turkey-breast model imitates is by definition a non-palpable one.[1][2] |
References
[edit source]- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Schmidt G, Gerlinger C, Endrikat J, Gabriel L, Müller C, Baus S, Volk T, Findeklee S, Solomayer EF, Hamza A, Ströder R. Teaching breast ultrasound skills including core-needle biopsies on a phantom enhances undergraduate student's knowledge and learning satisfaction. Archives of Gynecology and Obstetrics 2021;304(1):197–202. DOI: 10.1007/s00404-021-06016-8. PMID 33728537. PMC PMC8164585.
- ↑ 2.0 2.1 2.2 Aydogan F, Mallory MA, Tukenmez M, Sagara Y, Ozturk E, Ince Y, Celik V, Akca T, Golshan M. A low cost training phantom model for radio-guided localization techniques in occult breast lesions. Journal of Surgical Oncology 2015;112(4):449–451. DOI: 10.1002/jso.23984. PMID 26250621. Abstract consulted; the figures quoted here are the abstract's own.