Breast Curvature of the Upper and Lower Breast Mound: 3D Analysis of Patients who Underwent Breast Reconstruction

Quantitative and objective methods to evaluate the morphology of the reconstructed breast may help plastic surgeons improve their surgical practice, and thus ultimately help breast cancer survivors derive the intended psychosocial benefits of reconstruction. Recently, we developed a quantitative and objective way to measure the curvature of the breast on standard clinical photographs. Here we conduct a more-in depth analysis of breast curvature using 3D images of the human torso. The analysis is based on the catenary curve, which is a perfectly flexible and inextensible string of uniform density supported by two distinct points. In this study, we used our curvature measure to study the upper and lower curvature of the breasts (breast curvature) of 9 patients who underwent breast reconstruction surgery. Breast reconstruction was performed using the autologous flap in 4 patients (5 breasts) and a tissue expander/implant (TE/Implant) in 5 patients (6 breasts). To assess the breast curvature, the outlines of the upper and lower breast were first obtained from coronal sectional views that are created from multiple parallel planes to the chest wall, which are spaced about 1 cm apart from each other. Then the curvature measure was extracted from the catenary contours fitted on the resulting outline of each sectional view. Our data show that breast curvatures of the upper and lower breast mound vary from the most anterior part of the breast mound to the chest wall. Moreover, our data suggest possible trends on the upper and lower breast curvature for different reconstruction types. For example, the opposite relationship was found between the upper and lower breast curvature for autologous and TE/Implant reconstructed breasts. In this study, we demonstrated a breast curvature measure for evaluating the outcome of breast reconstruction, especially for the curvature of the upper and lower breast mounds, based on 3D torso images of patients.