Pectoralis Major Muscle 3D Volumetric Reconstruction in the Tuberous Breast: Anatomical and Radiomics Differences With Potential Surgical Impact.

Background: Tuberous breast (TB) is a congenital anomaly characterized by morphological, structural, and breast region alterations. The pectoralis major muscle (PMM) is crucial for correction when placing breast implants. Alterations at this level have received little attention in the literature.

Objectives: In this study we aimed to define the anatomical characteristics of the PMM in TB patients with radiomics data extracted from MRI sequences.

Methods: The PMMs of 30 TB patients and 30 controls were analyzed by manual segmentation with 3D-Slicer v.5.4.0 software and radiomics techniques. A total of 46 features were extracted, both first-order statistical features and shape features (eg, median, mean, standard deviation, volume, area, centroid, number of voxels, flatness, roundness, elongation, principal axis length x, y, z, diameter).

Results: A statistically significant difference was found in favor of the TB group for PMM roundness; PMM elongation was greater in the TB group. Principal axes 1, 2, and 3 were analyzed in the 3 planes x, y, and z. In the TB group, principal x axis 3 was lower than in the control group. Also, between the axes, principal z axis 2 was on average higher in the TB group than in the non-TB group.

Conclusions: These results provide the first quantitative evidence of alterations affecting the PMM in TB patients. These differences were found in different planes and volumetric shape features, with potential surgical implications.

Level of evidence: 4: (Therapeutic).