BREAST-V Versus MRI for Breast Volume Assessment Before and After Breast Asymmetry Surgery: Good Preoperative Association but Limited Postoperative Interchangeability

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ID: 328025
2026
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Abstract
BACKGROUND: Objective breast volume measurement is critical for breast asymmetry surgery. BREAST-V is a practical anthropometric formula, but its interchangeability with MRI, particularly after surgery, is unclear. OBJECTIVES: To evaluate agreement between BREAST-V and MRI before and after breast asymmetry surgery. METHODS: Forty patients underwent preoperative and postoperative MRI and BREAST-V assessments. Agreement was evaluated using ICC, Bland-Altman analysis, and error metrics. Intraoperative field changes were recorded, an MRI-based MCID was derived using distribution-based methods, and satisfaction was assessed with BREAST-Q. RESULTS: Preoperatively, BREAST-V showed good association and moderate agreement with MRI (ICC = 0.788; r = 0.840; p < 0.001). Postoperatively, agreement was poor (ICC = 0.210; r = 0.339; p = 0.032). Bland-Altman bias increased from +69.5 mL preoperatively to +279.2 mL postoperatively, with wide limits of agreement (-366.4 to +505.5 mL and -67.2 to +625.7 mL, respectively). Error metrics showed clinically relevant divergence, particularly postoperatively (mean absolute error, 177.6 vs 280.5 mL; mean absolute percentage error, 35.5% vs 41.0%). The MRI-derived MCID for asymmetry was 92.5 mL. Among 30 patients with paired BREAST-Q data, Satisfaction with Breasts improved from 25.0 ± 24.1 to 81.0 ± 12.7 points (mean improvement, 56.0; 95% CI, 46.4-65.6; p < 0.001). CONCLUSIONS: BREAST-V may be useful for preoperative planning but should not be considered interchangeable with MRI after surgical remodeling.
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Authors JOSÉ RENATO NAHLOUS FERREIRA LEITE, Mayara Mytzi de Aquino Silva, Juan Carlos Montano Pedroso, Marcelo Moraes Trincado, Gabriel de Almeida Arruda Felix, Miguel Sabino Neto
Journal Aesthetic surgery journal
Year 2026
DOI
10.1093/asj/sjag178
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