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Is Breast Asymmetry Present in Girls with Adolescent Idiopathic Scoliosis?

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Abstract

Study Design

Cross-sectional descriptive study.

Objectives

To characterize breast asymmetry (BA), as defined by breast volume difference, in girls with significant adolescent idiopathic scoliosis (AIS), using magnetic resonance imaging (MRI).

Summary of Background Data

BA is a frequent concern among girls with AIS. It is commonly believed that this results from chest wall deformity. Although many women exhibit physiological BA, the prevalence is not known in adolescents and it remains unclear if it is more frequent in AIS. Breasts vary in shape and size and many ways of measuring them have been explored. MRI shows the highest precision at defining breast tissue.

Methods

Thirty patients were enrolled on the basis of their thoracic curvature, skeletal and breast maturity, without regard to their perception on their BA. MRI acquisitions were performed in prone with a 1.5-Tesla system using a 16-channel breast coil. Segmentation was achieved using the ITK-SNAP 2.4.0 software and subsequently manually refined.

Results

The mean left breast volume (528.32 ± 205.96 cc) was greater compared with the mean right breast volume (495.18 ± 170.16 cc) with a significant difference between them. The mean BA was found to be 8.32% ± 6.43% (p <.0001). A weak positive correlation was observed between BA and thoracic Cobb angle (0.177, p =.349) as well as thoracic gibbosity angle (0.289, p =.122). The left breast was consistently larger in 65.5% of the patients. Twenty patients (66.7%) displayed BA 3⩾5%.

Conclusions

We have described BA in patients with significant AIS using MRI. This method is feasible, objective, and very precise. The majority of patients had a larger left breast, which could compound the apparent BA secondary to trunk rotation. In many cases, BA is present independently of thoracic deformity. This knowledge will assist in counseling AIS patients in regards to their concerns with BA.

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Authors and Affiliations

  1. Division of Orthopedics, Sainte-Justine University Hospital Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montreal, Quebec, H3T 1C5, Canada

    Joyce Ramsay MD, MSc, PT, Julie Joncas RN, BSc, Farida Cheriet PhD, Hubert Labelle MD & Stefan Parent MD, PhD

  2. University of Montreal, 2910 Edouard-Montpetit Blvd, Montreal, Quebec, H3C 3J7, Canada

    Joyce Ramsay MD, MSc, PT & Stefan Parent MD, PhD

  3. MR Clinical Science, Philips Healthcare, 281 Hillmount Road, Markham, Ontario, L6C 2S3, Canada

    Guillaume Gilbert PhD

  4. Hôtel-Dieu University of Montreal Hospital Center, 3840 Saint Urbain Street, Montreal, Quebec, H2W 1T8, Canada

    Guillaume Gilbert PhD & Isabelle Trop MD, MPH

  5. Polytechnique Montreal, 2500 Chemin de Polytechnique, Montreal, Quebec, H3T 1J4, Canada

    Farida Cheriet PhD

Authors
  1. Joyce Ramsay MD, MSc, PT
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  2. Julie Joncas RN, BSc
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  3. Guillaume Gilbert PhD
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  4. Isabelle Trop MD, MPH
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  5. Farida Cheriet PhD
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  6. Hubert Labelle MD
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  7. Stefan Parent MD, PhD
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Corresponding author

Correspondence to Stefan Parent MD, PhD.

Additional information

Author disclosures: JR (none); JJ (none); GG (personal fees from Philips Healthcare, outside the submitted work); IT (none); FC (none); HL (grants from Canadian Institutes of Health Research (Grant no.: MPO-125875), during the conduct of the study); SP (grants from Academic Research Chair on Pediatric Spinal Deformities of CHU Ste-Justine, during the conduct of the study; grants from Canadian Institutes of Health Research, grants from Orthopaedic Research and Education Foundation (Grant no.: PCIPJ 346145-11), grants from Natural Sciences and Engineering Research Council of Canada, grants from Fonds de Recherche Québec—Santé (Grant no.: 29055), grants from Setting Scoliosis Straight Foundation, personal fees and nonfinancial support from Medtronic, personal fees and nonfinancial support from Depuy Synthes Spine, personal fees and nonfinancial support from EOS-Imaging, nonfinancial support and other from Spinologics, outside the submitted work).

This study was supported in part by the Academic Research Chair on Pediatric Spinal Deformities of CHU-Sainte-Justine and MENTOR, a strategic training program of the Canadian Institute of Health Research.

This study is a result of collaboration between 3 university institutions in Montreal, Canada.

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Ramsay, J., Joncas, J., Gilbert, G. et al. Is Breast Asymmetry Present in Girls with Adolescent Idiopathic Scoliosis?. Spine Deform 2, 374–379 (2014). https://doi.org/10.1016/j.jspd.2014.05.002

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  • DOI: https://doi.org/10.1016/j.jspd.2014.05.002

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