The effect of delayed breast reconstruction after unilateral mastectomy on spine alignment

Background: Mastectomy in patients with breast cancer causes spinal deformities. We evaluated the effect of delayed breast reconstruction in post-mastectomy patients on spine alignments.

Methods: The study included 68 patients who underwent delayed breast reconstruction by three plastic surgeons in a single tertiary hospital. We measured proximal thoracic (PT), main thoracic (MT), and thoracolumbar (TL) Cobb angles and coronal spinal balance from chest or whole spine radiographs.

Results: The median changes in the PT and MT Cobb angles were -0.33 and -0.34 degrees, respectively. The change in TL Cobb angle and coronal spinal balance were only measured in 29 patients with available spine radiographs. The median change in TL Cobb angle and coronal spinal balance were -0.69 degrees and 3.75 mm, respectively. The median preoperative and postoperative PT Cobb angles were 1.75 and 1.24 degrees. The difference between preoperative and postoperative PT Cobb angles was statistically insignificant (P=0.036). The median preoperative and postoperative MT Cobb angles were 1.32 and 1.09 degrees, respectively. The difference between preoperative and postoperative MT Cobb angles was statistically insignificant (P=0.221).

Conclusions: Delayed breast reconstruction did not result in clinically significant improvement in mastectomy-induced spinal deformity. This finding should be considered when choosing between immediate and delayed breast reconstruction.