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Comparative Study
. 2016 Jan-Feb;22(1):10-7.
doi: 10.1111/tbj.12542.

Psychosocial and Sexual Well-Being Following Nipple-Sparing Mastectomy and Reconstruction

Cindy H Wei  1 , Amie M Scott  1 , Alison N Price  1 , Helen Catherine Miller  1 , Anne F Klassen  2 , Sabrina M Jhanwar  1 , Babak J Mehrara  1 , Joseph J Disa  1 , Colleen McCarthy  1 , Evan Matros  1 , Peter G Cordeiro  1 , Virgilio Sacchini  3 , Andrea L Pusic  1
Affiliations
Comparative Study

Psychosocial and Sexual Well-Being Following Nipple-Sparing Mastectomy and Reconstruction

Cindy H Wei et al. Breast J. 2016 Jan-Feb.

Abstract

Nipple-sparing mastectomy (NSM) is considered an oncologically safe option for select patients. As many patients are candidates for nipple-sparing or skin-sparing mastectomy (SSM), reliable patient-reported outcome data are crucial for decision-making. The objective of this study was to determine whether patient satisfaction and/or health-related quality of life (HRQOL) were improved by preservation of the nipple with NSM compared to SSM and nipple reconstruction. Subjects were identified from a prospectively maintained database of patients who completed the BREAST-Q following mastectomy and breast reconstruction between March and October 2011 at Memorial Sloan Kettering Cancer Center. Fifty-two patients underwent NSM followed by immediate expander-implant reconstruction. A comparison group consisted of 202 patients who underwent SSM followed by immediate expander-implant reconstruction and later nipple reconstruction. HRQOL and satisfaction domains as measured by BREAST-Q scores were compared in multivariate linear regression analyzes that controlled for potential confounding factors. NSM patients reported significantly higher scores in the psychosocial (p = 0.01) and sexual well-being (p = 0.02) domains compared to SSM patients. There was no significant difference in the BREAST-Q physical well-being, satisfaction with breast, or satisfaction with outcome domains between the NSM and SSM groups. NSM is associated with higher psychosocial and sexual well-being compared to SSM and nipple reconstruction. Preoperative discussion of such HRQOL outcomes with patients may facilitate informed decision-making and realistic postoperative expectations.

Keywords: BREAST-Q; breast reconstruction; health-related quality of life; implant reconstruction; nipple-sparing mastectomy.

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Figures

Figure 1
Figure 1
BREAST-Q psychosocial and sexual well-being scales.
See this image and copyright information in PMC

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