Breast asymmetry classification and diagnostics

Breast asymmetry is a polyetiological condition, which may be caused by congenital characteristics, developmental abnormalities, hormonal changes, traumas or surgery. The estimation of breast symmetry should be performed by the plastic surgeon while planning the augmentation or reduction mammoplasty as well as reconstructive surgery. Breast asymmetry is a widespread condition, according to some reports, it can be found in more than half of women. Anthropometric methods, as well as radiology methods, are used to diagnose and estimate breast asymmetry. There are many classification systems of breast asymmetry. The first ones were based on breast appearance or etiology of asymmetry, while modern classifications combine morphologic and etiologic principles. Today there is no conventional diagnostic protocol for breast asymmetry, where it would be listed, which breast parameters should be measured during breast asymmetry estimation. The first attempts were made in the middle of the XX century. Works of Penn, Smith and Westreich are considered to be basic in this field. Generally, relationships between major breast soft-tissue reference points (nipple, areola, submammary fold, lateral border) and bone structures (breastbone, jugular notch, clavicle) are estimated.Mathematic formulas for counting breast volume depending on its linear measurements were developed as well. Nowadays the importance of skeleto-muscular system state (the presence of scoliosis or rib cage deformation) estimation is emphasized, while these conditions can also cause breast asymmetry.