The Effect of Immediate Breast Reconstruction on Thoracic Spine Alignment After Unilateral Mastectomy

Long-term posture change after unilateral mastectomy in breast cancer patients can affect spinal alignment during the postoperative period. We evaluated the effect of immediate breast reconstruction on body posture after surgery by analyzing spinal alignment with radiographic studies.

Preoperative and 2-year postoperative chest radiographs of 116 patients who received immediate breast reconstruction with unilateral mastectomy and 250 patients who underwent unilateral mastectomy without reconstruction were retrospectively reviewed. Cobb angle, the direction of spinal curvature, upper and lower ends of the thoracic curve, and curve length were measured and compared between both groups. Additional patient information including age, height, weight, body mass index, and side of surgery were collected via chart review.

There was a significant difference in the Cobb angle between the preoperative and 2-year postoperative chest radiographs between the immediate breast reconstruction group and mastectomy group. Without considering curvature change, the difference was -0.593° in the reconstruction group and 2.698° in the mastectomy-alone group (P = .02), and considering curvature change, the difference was 0.335° and 3.972° in the reconstruction and mastectomy-alone group, respectively (P < .01).

The amount of change in postoperative spinal alignment was significantly smaller in the immediate breast reconstruction group compared with patients who received only unilateral mastectomy without reconstruction. We suggest that immediate breast reconstruction positively affects spinal alignment, leading to better posture and physical function.