Breast CancerABCDNCT05450016
Assessment of the Breast Cosmesis Using Deep Neural Networks: an Exploratory Study (ABCD)
An observational study of Breast Cancer, run by Tata Memorial Centre at 1 site in India.
Trial summary
Surgery and radiotherapy in breast cancer patients can cause treatment changes and may affect the final breast appearance. In this study, we are trying to evaluate the post treatment breast photographs of the patients and subject these to Artificial Intelligence based program so as to classify into appropriate… Read more about this study
- Who is it for?
- Ages 19 to 80 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Breast Cancer
- How many people
- 720 participants
- Where
- 1 siteIndia
- Study dates
- 4 Oct 2021to Sep 2026
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 19 to 80 years
- Women only
- Healthy volunteers accepted
- Adult, Older adult
Study population: This is a retrospective analysis of patient photographs that have been acquired after written informed consent as per ethical requirements. The patients accrued in the ongoing prospective study (CTRI/2020/01/022871) have been re-consented for the current study in order to subject their breast photographs for neural network analysis. No photographs are taken separately for the current study. Hence this is essentially a retrospective study of the breast photographs to predict cosmesis.
Who may be able to join
- Confirmed diagnosis of primary breast cancer (invasive or in situ)
- Patient undergone breast conservation / Whole breast reconstruction
- Patient received breast RT
- Already provided written informed consent on earlier projects
- Patient provided photographs of both breasts
- Non-metastatic disease or oligometastatic
- Age > 18 years
- Reconsent given
Who cannot join
- Mastectomy without whole breast reconstruction
- Bilateral breast cancer
- Partial breast irradiation
- Male patient
- Limited life expectancy due to co-morbidity
- Patients undergoing brachy boost
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
India1 site, 1 recruiting
- Recruiting
Tata Memorial Centre
Mumbai, Maharashtra, 400012
Tabassum Wadasadawala, MD, 9324445303, twadasadawala@actrec.gov.in
Tabassum Wadasadawala, MD
About this study
Surgery and radiotherapy in breast cancer patients can cause treatment changes and may affect the final breast appearance. In this study, we are trying to evaluate the post treatment breast photographs of the patients and subject these to Artificial Intelligence based program so as to classify into appropriate categories based upon changes from baseline. This automated solution will help in decreasing the time required to achieve this task by physicians in the clinic.
Read the detailed description
A new algorithm was introduced which is based on deep neural network (DNN) which receives an image as input and returns the coordinates of the breast key points as output. These key points are then given to a shortest-path algorithm that models images as graphs to refine breast key point localization. The algorithm learns, directly from the image, to compute features and to use those features in the analysis of the aesthetic result. This comprises of two main modules: regression and refinement of heatmaps, and regression of key points. To perform the heatmap regression, the U-Net model is used.
The goal of the first module is to generate an intermediate representation consisting on a fuzzy localization for the key points that are to be detected.
The second module receives and refines this fuzzy localization, and through complex calculations, outputting the x and y coordinates of the keypoints, and the data generated from which can be used for disease / image classification.
- Conditions
- Breast Cancer
- Keywords
- Cosmesis, photographic assessment, neural network
- Medical subject headings
- Breast Neoplasms
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of patients with excellent/good cosmesis
The patient photographs will be processed for artificial intelligence based analysis of prediction of breast cosmesis
Measured: 3 years
Secondary outcomes (1)
Kappa statistic between different deep neural networks
Concordance of various deep neural networks in prediction of breast cosmesis
Measured: 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 Jul 2022
- Study start4 Oct 2021
- Primary completionDec 2025 (estimated)
- Study completionSep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (21)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- More trials run by Tata Memorial CentreThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 720 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Tata Memorial Centre
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Dr. Tabassum Wadasadawala, Tata Memorial Centre
- Investigators
- Tabassum Wadasadwala, MD, Principal investigator, Tata Memorial Centre
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05450016
- Sponsor's protocol ID
- 3734
- Acronym
- ABCD
- Status last verified
- Apr 2025
- First submitted
- 28 Jun 2022
- Last updated
- 10 Apr 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Hill-Kayser CE, Vachani C, Hampshire MK, Di Lullo GA, Metz JM. Cosmetic outcomes and complications reported by patients having undergone breast-conserving treatment. Int J Radiat Oncol Biol Phys. 2012 Jul 1;83(3):839-44. doi: 10.1016/j.ijrobp.2011.08.013. Epub 2011 Dec 2.
PubMed 22137022Cardoso JS, Silva W, Cardoso MJ. Evolution, current challenges, and future possibilities in the objective assessment of aesthetic outcome of breast cancer locoregional treatment. Breast. 2020 Feb;49:123-130. doi: 10.1016/j.breast.2019.11.006. Epub 2019 Nov 21.
PubMed 31790958Vrieling C, Collette L, Bartelink E, Borger JH, Brenninkmeyer SJ, Horiot JC, Pierart M, Poortmans PM, Struikmans H, Van der Schueren E, Van Dongen JA, Van Limbergen E, Bartelink H. Validation of the methods of cosmetic assessment after breast-conserving therapy in the EORTC "boost versus no boost" trial. EORTC Radiotherapy and Breast Cancer Cooperative Groups. European Organization for Research and Treatment of Cancer. Int J Radiat Oncol Biol Phys. 1999 Oct 1;45(3):667-76. doi: 10.1016/s0360-3016(99)00215-1.
PubMed 10524421Kim MS, Reece GP, Beahm EK, Miller MJ, Atkinson EN, Markey MK. Objective assessment of aesthetic outcomes of breast cancer treatment: measuring ptosis from clinical photographs. Comput Biol Med. 2007 Jan;37(1):49-59. doi: 10.1016/j.compbiomed.2005.10.007. Epub 2006 Jan 24.
PubMed 16438948Pezner RD, Patterson MP, Hill LR, Vora N, Desai KR, Archambeau JO, Lipsett JA. Breast retraction assessment: an objective evaluation of cosmetic results of patients treated conservatively for breast cancer. Int J Radiat Oncol Biol Phys. 1985 Mar;11(3):575-8. doi: 10.1016/0360-3016(85)90190-7.
PubMed 3972667Pezner RD, Lipsett JA, Vora NL, Desai KR. Limited usefulness of observer-based cosmesis scales employed to evaluate patients treated conservatively for breast cancer. Int J Radiat Oncol Biol Phys. 1985 Jun;11(6):1117-9. doi: 10.1016/0360-3016(85)90058-6.
PubMed 3997593Lowery JC, Wilkins EG, Kuzon WM, Davis JA. Evaluations of aesthetic results in breast reconstruction: an analysis of reliability. Ann Plast Surg. 1996 Jun;36(6):601-6; discussion 607. doi: 10.1097/00000637-199606000-00007.
PubMed 8792969Cohen M, Evanoff B, George LT, Brandt KE. A subjective rating scale for evaluating the appearance outcome of autologous breast reconstruction. Plast Reconstr Surg. 2005 Aug;116(2):440-9. doi: 10.1097/01.prs.0000173214.05854.e4.
PubMed 16079671Cardoso MJ, Cardoso JS, Wild T, Krois W, Fitzal F. Comparing two objective methods for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat. 2009 Jul;116(1):149-52. doi: 10.1007/s10549-008-0173-4. Epub 2008 Sep 7.
PubMed 18777134Fitzal F, Krois W, Trischler H, Wutzel L, Riedl O, Kuhbelbock U, Wintersteiner B, Cardoso MJ, Dubsky P, Gnant M, Jakesz R, Wild T. The use of a breast symmetry index for objective evaluation of breast cosmesis. Breast. 2007 Aug;16(4):429-35. doi: 10.1016/j.breast.2007.01.013. Epub 2007 Mar 26.
PubMed 17382546START Trialists' Group; Bentzen SM, Agrawal RK, Aird EG, Barrett JM, Barrett-Lee PJ, Bliss JM, Brown J, Dewar JA, Dobbs HJ, Haviland JS, Hoskin PJ, Hopwood P, Lawton PA, Magee BJ, Mills J, Morgan DA, Owen JR, Simmons S, Sumo G, Sydenham MA, Venables K, Yarnold JR. The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol. 2008 Apr;9(4):331-41. doi: 10.1016/S1470-2045(08)70077-9. Epub 2008 Mar 19.
PubMed 18356109START Trialists' Group; Bentzen SM, Agrawal RK, Aird EG, Barrett JM, Barrett-Lee PJ, Bentzen SM, Bliss JM, Brown J, Dewar JA, Dobbs HJ, Haviland JS, Hoskin PJ, Hopwood P, Lawton PA, Magee BJ, Mills J, Morgan DA, Owen JR, Simmons S, Sumo G, Sydenham MA, Venables K, Yarnold JR. The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 2008 Mar 29;371(9618):1098-107. doi: 10.1016/S0140-6736(08)60348-7. Epub 2008 Mar 19.
PubMed 18355913Wadasadawala T, Sinha S, Parmar V, Verma S, Gaikar M, Kannan S, Mondal M, Pathak R, Jain U, Sarin R. Comparison of subjective, objective and patient-reported cosmetic outcomes between accelerated partial breast irradiation and whole breast radiotherapy: a prospective propensity score-matched pair analysis. Breast Cancer. 2020 Mar;27(2):206-212. doi: 10.1007/s12282-019-01009-7. Epub 2019 Sep 11.
PubMed 31512161Wadasadawala T, Sinha S, Verma S, Parmar V, Kannan S, Pathak R, Sarin R, Gaikar M. A prospective comparison of subjective and objective assessments of cosmetic outcomes following breast brachytherapy. J Contemp Brachytherapy. 2019 Jun;11(3):207-214. doi: 10.5114/jcb.2019.85414. Epub 2019 Jun 28.
PubMed 31435427Maier A, Syben C, Lasser T, Riess C. A gentle introduction to deep learning in medical image processing. Z Med Phys. 2019 May;29(2):86-101. doi: 10.1016/j.zemedi.2018.12.003. Epub 2019 Jan 25.
PubMed 30686613
Study at a glance
From the registry record, last updated by the sponsor on 10 Apr 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Assessment of the Breast Cosmesis Using Deep Neural Networks: an Exploratory Study (ABCD)
- ClinicalTrials.gov ID
- NCT05450016
- Acronym / sponsor ID
- ABCD / 3734
- Conditions
- Breast Cancer
- Keywords
- Cosmesis, photographic assessment, neural network
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 720 participants (estimated)
- Lead sponsor
- Tata Memorial CentreUniversity, hospital or other
- Study start
- 4 Oct 2021 (actual)
- Primary completion
- Dec 2025 (estimated)
- Study completion
- Sep 2026 (estimated)
- First posted
- 8 Jul 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Surgery and radiotherapy in breast cancer patients can cause treatment changes and may affect the final breast appearance. In this study, we are trying to evaluate the post treatment breast photographs of the patients and subject these to Artificial Intelligence based program so as to classify into appropriate categories based upon changes from baseline. This automated solution will help in decreasing the time required to achieve this task by physicians in the clinic.
Detailed description
A new algorithm was introduced which is based on deep neural network (DNN) which receives an image as input and returns the coordinates of the breast key points as output. These key points are then given to a shortest-path algorithm that models images as graphs to refine breast key point localization. The algorithm learns, directly from the image, to compute features and to use those features in the analysis of the aesthetic result. This comprises of two main modules: regression and refinement of heatmaps, and regression of key points. To perform the heatmap regression, the U-Net model is used.
The goal of the first module is to generate an intermediate representation consisting on a fuzzy localization for the key points that are to be detected.
The second module receives and refines this fuzzy localization, and through complex calculations, outputting the x and y coordinates of the keypoints, and the data generated from which can be used for disease / image classification.
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
Who may qualify
- Ages
- 19 to 80 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- This is a retrospective analysis of patient photographs that have been acquired after written informed consent as per ethical requirements. The patients accrued in the ongoing prospective study (CTRI/2020/01/022871) have been re-consented for the current study in order to subject their breast photographs for neural network analysis. No photographs are taken separately for the current study. Hence this is essentially a retrospective study of the breast photographs to predict cosmesis.
Key inclusion criteria (8 listed)
- Confirmed diagnosis of primary breast cancer (invasive or in situ)
- Patient undergone breast conservation / Whole breast reconstruction
- Patient received breast RT
- Already provided written informed consent on earlier projects
- Patient provided photographs of both breasts
Key exclusion criteria (6 listed)
- Mastectomy without whole breast reconstruction
- Bilateral breast cancer
- Partial breast irradiation
- Male patient
- Limited life expectancy due to co-morbidity
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Proportion of patients with excellent/good cosmesis
Time frame: 3 years
The patient photographs will be processed for artificial intelligence based analysis of prediction of breast cosmesis
1 secondary outcome
Kappa statistic between different deep neural networks
Time frame: 3 years
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Apr 2025.
- Results publication: PubMed 22137022Hill-Kayser CE, Vachani C, Hampshire MK, Di Lullo GA, Metz JM. Cosmetic outcomes and complications reported by patients having undergone breast-conserving treatment. Int J Radiat Oncol Biol Phys. 2012 Jul 1;83(3):839-44. doi: 10.1016/j.ijrobp.2011.08.013. Epub 2011 Dec 2.
- Results publication: PubMed 31790958Cardoso JS, Silva W, Cardoso MJ. Evolution, current challenges, and future possibilities in the objective assessment of aesthetic outcome of breast cancer locoregional treatment. Breast. 2020 Feb;49:123-130. doi: 10.1016/j.breast.2019.11.006. Epub 2019 Nov 21.
- Results publication: PubMed 10524421Vrieling C, Collette L, Bartelink E, Borger JH, Brenninkmeyer SJ, Horiot JC, Pierart M, Poortmans PM, Struikmans H, Van der Schueren E, Van Dongen JA, Van Limbergen E, Bartelink H. Validation of the methods of cosmetic assessment after breast-conserving therapy in the EORTC "boost versus no boost" trial. EORTC Radiotherapy and Breast Cancer Cooperative Groups. European Organization for Research and Treatment of Cancer. Int J Radiat Oncol Biol Phys. 1999 Oct 1;45(3):667-76. doi: 10.1016/s0360-3016(99)00215-1.
- Results publication: PubMed 16438948Kim MS, Reece GP, Beahm EK, Miller MJ, Atkinson EN, Markey MK. Objective assessment of aesthetic outcomes of breast cancer treatment: measuring ptosis from clinical photographs. Comput Biol Med. 2007 Jan;37(1):49-59. doi: 10.1016/j.compbiomed.2005.10.007. Epub 2006 Jan 24.
- Results publication: PubMed 3972667Pezner RD, Patterson MP, Hill LR, Vora N, Desai KR, Archambeau JO, Lipsett JA. Breast retraction assessment: an objective evaluation of cosmetic results of patients treated conservatively for breast cancer. Int J Radiat Oncol Biol Phys. 1985 Mar;11(3):575-8. doi: 10.1016/0360-3016(85)90190-7.
- Results publication: PubMed 3997593Pezner RD, Lipsett JA, Vora NL, Desai KR. Limited usefulness of observer-based cosmesis scales employed to evaluate patients treated conservatively for breast cancer. Int J Radiat Oncol Biol Phys. 1985 Jun;11(6):1117-9. doi: 10.1016/0360-3016(85)90058-6.
- Results publication: PubMed 8792969Lowery JC, Wilkins EG, Kuzon WM, Davis JA. Evaluations of aesthetic results in breast reconstruction: an analysis of reliability. Ann Plast Surg. 1996 Jun;36(6):601-6; discussion 607. doi: 10.1097/00000637-199606000-00007.
- Results publication: PubMed 16079671Cohen M, Evanoff B, George LT, Brandt KE. A subjective rating scale for evaluating the appearance outcome of autologous breast reconstruction. Plast Reconstr Surg. 2005 Aug;116(2):440-9. doi: 10.1097/01.prs.0000173214.05854.e4.
- Results publication: PubMed 18777134Cardoso MJ, Cardoso JS, Wild T, Krois W, Fitzal F. Comparing two objective methods for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat. 2009 Jul;116(1):149-52. doi: 10.1007/s10549-008-0173-4. Epub 2008 Sep 7.
- Results publication: PubMed 17382546Fitzal F, Krois W, Trischler H, Wutzel L, Riedl O, Kuhbelbock U, Wintersteiner B, Cardoso MJ, Dubsky P, Gnant M, Jakesz R, Wild T. The use of a breast symmetry index for objective evaluation of breast cosmesis. Breast. 2007 Aug;16(4):429-35. doi: 10.1016/j.breast.2007.01.013. Epub 2007 Mar 26.
- Results publication: PubMed 18356109START Trialists' Group; Bentzen SM, Agrawal RK, Aird EG, Barrett JM, Barrett-Lee PJ, Bliss JM, Brown J, Dewar JA, Dobbs HJ, Haviland JS, Hoskin PJ, Hopwood P, Lawton PA, Magee BJ, Mills J, Morgan DA, Owen JR, Simmons S, Sumo G, Sydenham MA, Venables K, Yarnold JR. The UK Standardisation of Breast Radiotherapy (START) Trial A of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet Oncol. 2008 Apr;9(4):331-41. doi: 10.1016/S1470-2045(08)70077-9. Epub 2008 Mar 19.
- Results publication: PubMed 18355913START Trialists' Group; Bentzen SM, Agrawal RK, Aird EG, Barrett JM, Barrett-Lee PJ, Bentzen SM, Bliss JM, Brown J, Dewar JA, Dobbs HJ, Haviland JS, Hoskin PJ, Hopwood P, Lawton PA, Magee BJ, Mills J, Morgan DA, Owen JR, Simmons S, Sumo G, Sydenham MA, Venables K, Yarnold JR. The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial. Lancet. 2008 Mar 29;371(9618):1098-107. doi: 10.1016/S0140-6736(08)60348-7. Epub 2008 Mar 19.
- YOLOv3: Real-Time Object Detection Algorithm (What's New?).Link provided by the sponsor.
- R-CNN, Fast R-CNN, Faster R-CNN, YOLO - Object Detection Algorithms.Link provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Tabassum Wadasadwala, MD principal investigator
Tata Memorial Centre
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Breast Cancer, run by Tata Memorial Centre at 1 site in India.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 10 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in India. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Tabassum Wadasadawala, MD (9324445303, twadasadwala@actrec.gov.in), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Proportion of patients with excellent/good cosmesis (time frame: 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05450016, which also lists 21 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Apr 2025.