Chest Wall Deformity and Rib Fractures in Breast Cancer Patients Following Reconstruction with Tissue Expanders

Breast cancer is the most frequent type of cancer in women and accounts for 11.6% of new cancer cases worldwide and 6.9% of cancer-related deaths. Breast surgery has evolved over time from radical mastectomy toward a preference for breast-conserving surgery and the widespread use of oncoplastic surgery. However, a subgroup of patients still undergo radical mastectomies with subsequent reconstruction via tissue expanders and breast implants. However, this subgroup of patients frequently exhibit mild-to-moderate chest wall deformities and, in rare instances, rib fractures, and the long-term effects of tissue expanders on chest wall deformity and rib fractures require further evaluation. The underlying cause is most likely a combination of metabolic changes due to systemic and hormonal treatment, radiotherapy, and local compression of the chest wall. Although imaging abnormalities appear relatively common in some studies, symptomatic complications and true rib fractures are uncommon and supported mainly by small-series and case reports. Further evaluation is required to determine if a subset of patients require treatment for this condition.