AGE-RELATED MORPHOMETRIC FEATURES OF BREAST STRUCTURE FOR THE SELECTION OF PLASTIC AND RECONSTRUCTIVE SURGICAL STRATEGIES

Introduction. The morphology of the mammary gland, as an endocrine organ, changes with age, depends on a woman’s hormonal status, is genetically determined, and may also be altered under the influence of inflammatory diseases of the female reproductive system. Therefore, timely detection of any breast tissue changes that deviate from normal (benign or malignant) significantly increases the chances of successful treatment and reduces mortality. In addition, age-related structural changes of the breast determine the choice of plastic and reconstructive surgical strategies and allow prediction of potentially unsatisfactory surgical outcomes. One of the main methods for early detection of morphological breast changes is mammography.Objective – to identify age-related morphological and morphometric patterns of breast structure in women, as well as anatomical variants relevant to the selection of plastic and reconstructive surgical strategies.Material and Methods. Morphometric analysis was performed in 200 women aged 18 to 57 years who underwent anthropometric assessment, including body mass index calculation and chest circumference measurement, followed by determination of three somatotypes according to the William Sheldon classification. The participants were divided into age groups based on the United Nations classification: adolescence (16-20 years, n = 100), early adulthood (21-35 years, n = 50), and late adulthood (36-60 years, n = 50). Mammography was performed using a standard technique in two projections.Results. Mammographic breast density and shape are determined by the ratio of glandular structures to stroma, which includes adipose and connective tissues. With increasing age, particularly during the postmenopausal period, physiological involution of glandular tissue occurs with its replacement by adipose tissue, which from a radiological perspective facilitates mammographic interpretation and increases diagnostic sensitivity. According to somatotype analysis, the most harmonious spatial proportions of the breast were observed in women with a normosthenic (mesomorphic) body type, in whom a hemispherical or spherical breast shape predominated (52.5% of cases). In women with an asthenic (ectomorphic) somatotype, conical and flattened breast forms were more frequently observed (30% of cases). The hypersthenic (endomorphic) somatotype was characterized by more massive and wider breast forms (spherical and pyramidal shapes in 65% of cases), reflecting features of transverse trunk development. Mammographically, adolescence was characterized by high and uniform breast tissue density, well-defined stromal and glandular components, and a clearly visualized ligamentous apparatus. Individually variable radiolucent areas of adipose tissue were mainly localized in the axillary and inframammary regions. In mature women, the radiological structure of breast parenchyma demonstrated marked individual variability: moderate fat deposition was most frequently observed in the axillary and inframammary regions, with occasional involvement of subcutaneous and retromammary zones, accompanied by reduced contrast between glandular-stromal and adipose components. Within glandular areas, thinning and uniform radiolucency of varying intensity of stromal, glandular, and ligamentous components were noted.Conclusions. Breast shape is a somatotype-dependent morphological characteristic that must be considered during preoperative planning with respect to age. Integration of somato-typological assessment into the clinical decision-making algorithm enables optimization of surgical technique selection, reduction of complication rates, and improvement of long-term aesthetic outcomes.