AB025. SOH24AB_041. Acquired scoliosis: a concerning finding in patients awaiting delayed deep inferior epigastric perforator (DIEP) breast reconstruction
Clinical Breast Session

AB025. SOH24AB_041. Acquired scoliosis: a concerning finding in patients awaiting delayed deep inferior epigastric perforator (DIEP) breast reconstruction

Sean Curran1, Rhys Van der Rijt1, Roisin Dolan2, Jamie Martin Smith1, Jake McDonald3, Joseph Butler3

1Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Beaumont, Dublin, Ireland; 2Royal College of Surgeons in Ireland, Department of Plastic & Reconstructive Surgery, Beaumont Hospital, Beaumont, Dublin, Ireland; 3National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland

Background: The exact mechanisms for postural changes in post-mastectomy chest wall asymmetry have yet to be determined. We sought to examine the effect of mastectomy on thoracolumbar spinal alignment in patients who underwent delayed deep inferior epigastric perforator (DIEP) breast reconstruction and to assess the relationship between duration of delay and severity of deviation.

Methods: A retrospective review of n=165 patients who underwent mastectomy followed by delayed DIEP breast reconstruction from 1/7/2020 to 30/6/2023 was performed. The degree of lateral spinal deviation was analysed using serial pre- and post-operative spinal imaging (radiographs or computed tomography). Cobb angles were calculated to define the angle of abnormal curvature, with a Cobb angle greater or equal to ten degrees consistent with a diagnosis of acquired scoliosis. Immediate implant-based reconstruction was identified as a potential protective factor.

Results: Ninety-three patients underwent delayed unilateral DIEP reconstruction. The average age of the cohort was 49.3 years. The mean interval from unilateral mastectomy to reconstruction was 1,132 days (95% confidence interval: 970–1,293). Unilateral delayed DIEP patients demonstrated a mean increase in Cobb angle of 4.45 degrees (95% confidence interval: 3.69–5.2, P value <0.001) versus an average increase of 1 degree (95% confidence interval: 0.347–1.65) in the bilateral delayed cohort.

Conclusions: This study suggests delay in breast reconstruction following mastectomy is directly associated with acquired lateral deviation of the spine, specifically unilateral mastectomy. Prospective follow-up is required to further objectively correlate clinical symptoms with radiological changes and to also ascertain whether DIEP reconstruction further serves as a corrective factor among those who have developed spinal deviation.

Keywords: Deep inferior epigastric perforator (DIEP); breast; Cobb angle; spine; scoliosis

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab025
Cite this abstract as: Curran S, Van der Rijt R, Dolan R, Martin Smith J, McDonald J, Butler J. AB025. SOH24AB_041. Acquired scoliosis: a concerning finding in patients awaiting delayed deep inferior epigastric perforator (DIEP) breast reconstruction. Mesentery Peritoneum 2024;8:AB025.

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