Virtual Human Twins for Personalized Breast Cancer Care
João Santinha and Tiago Marques, Principal Investigators, representing the research team affiliated with the BCRP Digital Surgery Lab

This project will establish the foundational infrastructure for Virtual Human Twins (VHTs) in breast cancer care at the Champalimaud Foundation’s Breast Department. We will combine two complementary research efforts from the Digital Surgery Lab: (i) AI-based predictive models developed from medical imaging and EHR-structured data (BreastCare), and (ii) patient-specific anatomical and biomechanical modelling with Extended Reality (XR) visualization tools. Our central hypothesis is that integrating AI models equipped with counterfactual approaches with intuitive patient-specific visualization will yield clinician-rated decision support that outperforms current static review on pre-specified usability and interpretability metrics, supporting personalized treatment planning, surgical decision-making, and shared understanding between
clinicians and patients.
By the end of the funding period, we expect to deliver a pilot translational infrastructure connecting clinical data, imaging-derived models, predictive algorithms, and visualization tools. This will generate proof-of concept data, scientific outputs, and a strong basis for future external funding applications focused on AI enabled, personalized breast cancer care.

Pretreatment Exercise and Chemotherapy Relative Dose Intensity in Breast Cancer: A Patient-Partner Randomized Feasibility Trial
Fernanda Z. Arthuso, PhD, Principal Investigator, representing the research team affiliated with the BCRP Physical Activity & Quality of Life Lab

The Pretreatment Exercise and Chemotherapy Relative Dose Intensity in Breast Cancer
(PRIME-BC), a patient-partnered randomized feasibility trial of a short-term exercise intervention prior to neoadjuvant chemotherapy in breast cancer patients presenting with frailty and/or sarcopenia at diagnosis. The study will generate evidence of both intervention feasibility
and preliminary efficacy of functional capacity in breast cancer patients with frailty and/or sarcopenia. The findings will inform a larger and adequately-powered trial examining the effects of prehabilitation exercise on neoadjuvant chemotherapy tolerance, supporting a 2028 Rising Tide Clinical Cancer Research grant application.

Bridging the Gap: Virtual Reality Immersion to Reduce Perioperative Anxiety and Improve Mental Health Outcomes in Breast Cancer Surgery
David Pinto, Principal Investigator, and Scott Rennie, Co-Principal Investigator, representing the research team affiliated with the BCRP SCOPE Lab

This project is explicitly patient-centered because its mechanism of action is patient experience. To accurately, understand and improve patient experience, it must be systematically modified and carefully measured. In two prior trials we did this by comparing VR’s impact on patient experience, measuring reductions in anxiety with survey measures, physiological recording and critically in a patient’s own words through structured interviews quantified by NLP. Patient feedback from these studies guided our previous methodologies and explicitly drives the content, form, and continuous-immersion protocol of our current proposal.