Abstract
Purpose
To evaluate the relationship between the degree of scoliotic curvature and postoperative change of the chest wall among patients who underwent a unilateral mastectomy.
Materials and Methods
Subjects were comprised of 56 women who underwent chest CT and a whole spine standing anteroposterior view (WSSAP). Cobb's angle and each side of the chest wall volume, including the breast, were measured with the WSSAP and a 3-D reconstructed multi-detector computed tomography (MDCT) image. A correlation analysis was performed between the scoliotic curvature and chest wall volume asymmetry. Directional correspondence between development of scoliosis and undergoing a mastectomy was analyzed. Furthermore, a survey on patient shoulder function was performed using a questionnaire and a correlation was performed between the results of the survey and the scoliotic curvature and chest wall volume asymmetry.
Results
The findings indicate that Cobb's angles were 4.4° ± 2.7 (Mean ± SD, range from 0.6 to 11.4). Differences in chest wall volume were 474.64 ± 276.36 cm3 (Mean ± SD, range from 78 to 1379). No statistical significance was noted between the degree of scoliotic curvature and chest wall volume asymmetry (p > 0.05). A cross-tabulation analysis of the direction between the scoliotic curvature and mastectomy was found to be statistically significant (p < 0.001). Also, there was a significant correlation between shoulder function assessment score and the degree of scoliotic curvature (p = 0.003), while no significant correlation between shoulder function assessment score and chest wall volume asymmetry (p = 0.091) could be found.
Figures and Tables
![]() | Fig. 1Measuring Cobb's angle by Cobb method of 44 years old female patient.
A. Preoperative chest plane radiograph.
B. Whole spine standing anteroposterior view after 4 years.
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![]() | Fig. 2Measured volume of the chest wall by 3D reconstructed volume rendering image of chest MDCT.
A. Whole chest wall volume is divided into 4 segments by right anterior (RtA), left anterior (LtA), right posterior (RtP), left posterior (LtP).
B. The muscle volume of chest wall is measured with 20-80 HU threshold (mRtA, mLtA, mRtP, mLtP).
Note.-MDCT = multi-detector computed tomography
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Table 2
Chest Wall Volume Differences in Mastectomy Patients by Chest MDCT with 3D Volume Reconstruction

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