A study on the correlation between MRI-assessed breast volume asymmetry and patient satisfaction after immediate breast reconstruction in breast cancer patients

Immediate breast reconstruction provides breast cancer patients with a valuable opportunity to restore breast shape. However, post-reconstruction breast asymmetry remains a common issue that affects patient satisfaction. This study aims to quantify breast asymmetry after surgery using magnetic resonance imaging (MRI) and assess its impact on both breast satisfaction and overall outcome satisfaction, offering scientific evidence to guide improvements in preoperative evaluation. We retrospectively collected MRI images and demographic characteristics from 98 patients who underwent unilateral immediate breast reconstruction. All patients underwent breast MRI scans post-reconstruction, and the MRI images were converted into 3D models using 3D Slicer software. The implant volumes were measured and compared with the actual implant volumes inserted during surgery to assess the accuracy of the MRI measurements. Breast symmetry after surgery was quantified using MRI-measured breast volumes, and patient satisfaction was analyzed through BREAST-Q questionnaires to explore the relationship between breast symmetry, post-reconstruction breast satisfaction, and overall outcome satisfaction. The implant volumes measured in the 3D reconstructed MRI images exhibited high concordance with the volumes recorded during surgery (r = 0.980, p < 0.001). Breast asymmetry values were significantly higher in the high BMI group compared to the low BMI group (P = 0.013), while the asymmetry ratio was significantly lower in the high weight group compared to the low weight group (P = 0.006). The asymmetry ratio showed a weak correlation with breast satisfaction (r = - 0.341, P = 0.002) and outcome satisfaction (r = - 0.371, P = 0.004). When grouped by low asymmetry (asymmetry > 10%), there was no significant difference in breast satisfaction (P = 0.054) or outcome satisfaction scores (P = 0.23) between the groups. However, in cases of high asymmetry (asymmetry ratio > 40%), breast satisfaction (P = 0.003) and outcome satisfaction scores (P = 0.005) were significantly lower in the asymmetry group compared to the symmetry group. Breast volume asymmetry after immediate breast reconstruction is associated with patient satisfaction, with a significant decrease in satisfaction when asymmetry exceeds 40%. This suggests that preoperative evaluation should focus on breast symmetry to improve post-reconstruction patient satisfaction and surgical outcomes.