DESIREE Communi...

“Last week I had my first mammography. It was a high quality digital mammography according to latest standards, followed by an ultrasound performed with a high resolution device by a specialized radiologist. No findings at all, as expected. The purpose of this examination was to serve as a reference for future ones! It is advised that women after 35 – and certainly before 40 years of age – have a reference digital mammography. This way we know exactly how our own breasts look like when healthy, so that any deviation is easily noticed and as soon as possible!” writes A. P. in her personal blog.


It is common sense nowadays that prevention and early diagnosis play an important role in almost any disease – with breast cancer being among the first in that list. Here are some facts:

  • Breast cancer has the highest mortality of any cancer in women worldwide.(1)
  • Breast cancer is the most common and most deadly type of cancer affecting woman in the EU countries, with more than 460,000 new cases and 130,000 deaths in 2012. (2)
  • 1 in 8 women in the EU-28 will develop breast cancer before the age of 85.(4)
  • An average of 20% of breast cancer cases in Europe occur in women when they are younger than 50 years old; 37% occur at age 50–64 and the remaining cases in women above this age.(3) Breast cancer therefore affects many women during their years dedicated to working and raising a family.

In that context, women are encouraged to be aware of signs and symptoms related to breast cancer, carry out regular self-examinations and follow closely their mammography frequency as per doctor advice. Breast cancer cannot be prevented, but it can be surely much better controlled if early detected!


October is Breast Cancer Awareness Month, a worldwide annual campaign involving thousands of organisations, unions and individuals with the objective to highlight the importance of breast awareness, education and research. So… dear ladies, have you planned your next mammography?

Acknowledging the high impact of breast cancer in the society, the European Union supports various initiatives on research, treatment and management of the disease. Among others, DESIREE project has received funding from the European Union´s Horizon 2020 research and innovation programme under grant agreement No 690238. DESIREE project aims at developing a web-based software ecosystem for the personalized, collaborative and multidisciplinary management of primary breast cancer (PBC) by specialized BUs. Decision support will be provided on the available therapy options by incorporating experience from previous cases and bringing a holistic view of the patient presented to the BU through specialized visual exploratory interfaces.


More information on DESIREE is available here.


(1).    Stewart BW, Wild CP, editors (2014). World Cancer Report 2014. Lyon, France: International Agency for Research on Cancer.
(2).    EUCAN 2012:
(3).    Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from:, accessed on 26/5/2015.
(4).    Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M et al. Cancer Incidence in Five Continents, Vol. IX, IARC Scientific Publications No. 160. IARCPress: Lyon: 2007.

DESIREE Communi...

The practice of medicine has evolved, during the last decades, from a doctor-centered art-practice to a regulated application of guidelines. This is particularly true in cancer medicine where therapeutic decisions have deep impact not only on chances of survival but, moreover, on toxicity and financial issues. This way, state of the art guideline compliance has become the standard and a routine obsession for practitioners.

Nevertheless, even the most detailed guideline bears wide areas of uncertainty or grey areas where the guideline recommendation ends in a blurred “consider one of the following options”. This fact is the result from the limitation of available evidence, particularly from the constraints that clinical trials have to reflect real life patient decisions. Hence, the generated disparity among centers can be remarkable in certain patients. Moreover, for these patients, where decision can vary from one day to another depending on not well captured reasoning, are not a source of clinical knowledge given the limitations of current patient record systems.

DESIREE has one of its major standpoints in the intelligence of the system to learn from decisions made on patients within these areas of uncertainty. Our focus is to allow the system to learn from the results of these decisions and present this knowledge to clinicians in the breast unit so the next time they decide on “grey” patients they can recall what they decided before and what the outcome of the decision was.

DESIREE will be a system that learns from uncertainty and transforms it into real world data based recommendation.


Dr. Ander Urruticoechea

Scientific and Managing Director

Fundación Onkologikoa

DESIREE Communi...

Zenodotus (Greek: Ζηνόδοτος) was a Greek grammarian, literary critic, Homeric scholar, and the first librarian of the Library of Alexandria, as explained by Wikipedia(1). He has also been the father of the first recorded use of metadata, a landmark in library history. Zenodotus introduced an organization system according to which small tags where attached to the end of each scroll containing information on each work’s author, title, and subject so that materials could be easily returned to the area in which they had been classified, but also so that library users did not have to unroll each scroll in order to see what it contained (1).

No, that was not the answer to the million-dollar question :-) This piece of information about Zenodotus, has been recently in discussion when Zenodo, the recently re-branded, catch-all, multidisciplinary repository for publications and data in multiple formats, was named after him! 

Zenodo was created to support the EC Open Data policy, according to which all beneficiaries must provide open access (free of charge, online access for any user) to all peer-reviewed publications by depositing them into a repository. Zenodo exposes its data to OpenAIRE, helping researchers to comply with the Open Access demands from the EC and the ERCs (2,3)

Zenodo in a nutshell (2)

•    Research. Shared. — all research outputs from across all fields of research are welcome! Sciences and Humanities, really!
•    Citeable. Discoverable. — uploads gets a Digital Object Identifier (DOI) to make them easily and uniquely citeable.
•    Communities — create and curate your own community for a workshop, project, department, journal, into which you can accept or reject uploads. Your own complete digital repository!
•    Funding — identify grants, integrated in reporting lines for research funded by the European Commission via OpenAIRE.
•    Flexible licensing — because not everything is under Creative Commons.
•    Safe — your research output is stored safely for the future in the same cloud infrastructure as CERN's own LHC research data.

Read more about Zenodo and its features.

DESIREE, as H2020 project, has selected this repository for its scientific publications created during the project lifecycle.



DESIREE Communi...

External radiation or brachytherapy is one of the treatment methods against breast cancer. As all therapies, radiation is linked with side effects. Utmost goal during the treatment with radiation is to maximize the benefit for the patient (efficacy of the treatment) while sparing other vital organs from radiation that could lead to organ’s toxicity.

The assessment of the overall benefit of a radiation treatment can be modelled with the help of linear quadratic model. That model simulates the cell killing for a specific type of cell (each cell cancerous or healthy has different properties: e.g. radiosensitivity, proliferation) under a given radiation prescription and schema.

With the help of such modelling, radiation oncologists can simulate and predict the outcome of any radiation treatment schema. Via treatment simulation, the best radiation treatment plan can be chosen and applied to a given patient.

DESIREE Communi...

Breast conserving therapy (BCT) refers to breast conserving surgery (BCS) followed by moderate-dose radiation therapy (RT) to eradicate any microscopic residual disease. The goals of BCT are to provide the survival equivalent of mastectomy, a cosmetically acceptable breast, and a low rate of recurrence in the treated breast.

Studies have shown that, after breast-conserving surgery, radiotherapy to the conserved breast halves the rate at which the disease recurs and reduces the breast cancer death rate by about a sixth. These proportional benefits vary little between different groups of women. By contrast, the absolute benefits from radiotherapy vary substantially according to the characteristics of the patient and they can be predicted at the time when treatment decisions need to be made.

One of the objectives of DESIREE is the development of a virtual surgery tool that can be applied in clinical practice. The patient will be able to visualise the final aesthetic outcome (cosmetically satisfactory and sensate breast) after breast conservative surgery, while the surgeon will be able to perform a virtual surgery on a three-dimensional model of the breast. The tool will be built on a patient-specific, predictive model of the outcome of BCT that is based on pre-operative imaging of the breast (MRI and 3D surface imaging). Our model combines a mechanical description of the breast tissues with a biological model of the wound healing at the cell level, encompassing multiple scales in space from cells to tissue, and time, from minutes for the tissue mechanics to months for healing. Prediction and simulation of the delivered radiation dose will be performed to quantify and evaluate the radiation treatment plan. Our multi-scale model is being validated with patient data resulting of a clinical trial currently underway .

DESIREE Communi...

In the previous post we discussed the effects of the project meeting in Paris regarding the everyday cooperation of the partners. Nevertheless this was by no means the only interesting aspect of the event. The content of the meeting itself and the quality additions to our team were the real issues of interest.

As a consortium, after an initial phase of requirements, we have made some progress in the understanding and initial developments of some of the core technologies of the project. Some of the main issues discussed where the architecture of the decision support system, its visual appearance, the information provided by imaging modalities, the role of genetics, the availability of data and the required validation protocols.

What is more, we have to underline the relevant presence for the first time of members of the Project Advisory Board. Drs Isabel Alvarez, Stuart McIntosh and Antonio Piñero, all experienced clinicians that know the specific needs of a Breast Unit and Nicole Zernik representing Europa Donna bringing the know-how and the perspective of the end user, all made it clear from the very beginning that their contribution will be extremely valuable.

They were able to understand the project aims, to put up with the current and future project developments and provide their views into the project objectives, offering advice and pointing out some specific issues necessary to keep into account for a successful endeavor. Among these we could mention the doctor requirements and patient needs, the shortcomings regarding data analytics and presentation of cases in the breast units, the possible role of imaging and genetics in breast cancer management, the possible use cases for radiobiological modelling or the need of development of interoperable solutions. We were delighted in any case to hear their positive views about the project and the hope that we could really successfully achieve what we are aiming at.