• Chien Lin Soh, Viraj Shah, Arian Arjomandi Rad, Robert Vardanyan, Alina Zubarevich, Saeed Torabi, Alexander Weymann, George Miller, and Johann Malawana.
• School of Clinical Medicine, University of Cambridge, Cambridge, UK.
• Br J Surg. 2022 Oct 14; 109 (11): 105310621053-1062.

BackgroundMachine learning is a set of models and methods that can automatically detect patterns in vast amounts of data, extract information, and use it to perform decision-making under uncertain conditions. The potential of machine learning is significant, and breast surgeons must strive to be informed with up-to-date knowledge and its applications.MethodsA systematic database search of Embase, MEDLINE, the Cochrane database, and Google Scholar, from inception to December 2021, was conducted of original articles that explored the use of machine learning and/or artificial intelligence in breast surgery in EMBASE, MEDLINE, Cochrane database and Google Scholar.ResultsThe search yielded 477 articles, of which 14 studies were included in this review, featuring 73 847 patients. Four main areas of machine learning application were identified: predictive modelling of surgical outcomes; breast imaging-based context; screening and triaging of patients with breast cancer; and as network utility for detection. There is evident value of machine learning in preoperative planning and in providing information for surgery both in a cancer and an aesthetic context. Machine learning outperformed traditional statistical modelling in all studies for predicting mortality, morbidity, and quality of life outcomes. Machine learning patterns and associations could support planning, anatomical visualization, and surgical navigation.ConclusionMachine learning demonstrated promising applications for improving breast surgery outcomes and patient-centred care. Neveretheless, there remain important limitations and ethical concerns relating to implementing artificial intelligence into everyday surgical practices.© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.

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