Physical Effects of Unilateral Mastectomy on Spine Deformity

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Abstract

Micro-Abstract

As mastectomy is known to effect body posture, we evaluated the long-term physical effects of unilateral mastectomy on spine deformity by radiographic examination of 60 women taken before and 12 months after the mastectomy. The results indicated long-term spinal deformation in women with unilateral mastectomy, suggesting informing patients of the possible change in body posture in the long-term.

Objective:

Mastectomy is known to effect body posture after a change in the center of gravity of women due to a missing breast. Although previous studies on short-term postural changes in mastectomy patients using photogrammetry or Moiré topography suggested ipsilateral inclination of the trunk, our clinical observations during breast reconstruction surgeries indicated a contralateral shoulder elevation in women with unilateral mastectomy. Because the change in body posture can affect spinal alignment, we aimed to evaluate the long-term physical effects of unilateral mastectomy on spine deformity by radiographic examination.

Methods:

Posteroanterior chest radiographs of 60 women (mean age 56.3 ± 8.5 years) taken before and 12 months after the mastectomy were evaluated for Cobb angle and the presence or absence of a tilt from the midline in the coronal plane of vertebral body alignment.

Results:

Cobb angle decreased in 14 and increased in 38 of 60 patients after unilateral mastectomy, and the angular change was found to be independent of the mastectomy side (P < .001). A shift in Cobb angle to the mastectomy side was observed in 11 of 53 patients (P > .05), whereas a statistically significant shift in Cobb angle to the opposite of the mastectomy side was observed in 33 of 53 patients (P < .001). The results of this observational retrospective study indicated long-term spinal deformation in women with unilateral mastectomy. Two patients with idiopathic scoliosis before mastectomy even developed scoliosis.

Conclusion:

We recommend informing the patients of the possible change in body posture in the long term, which should be supported or limited with physical therapy.

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