Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 9;60(10):1655.
doi: 10.3390/medicina60101655.

Evaluation of Breast Skin/Nipple-Areolar Complex Sensation and Quality of Life after Nipple-Sparing Mastectomy Followed by Reconstruction

Beatriz Soares Domingues Polita  1 , Jānis Lapinš  1   2 , Ansis Ģīlis  2 , Michal Grucki  1 , Arvids Irmejs  2   3 , Jānis Gardovskis  1   2 , Jeļena Maksimenko  2   3
Affiliations

Evaluation of Breast Skin/Nipple-Areolar Complex Sensation and Quality of Life after Nipple-Sparing Mastectomy Followed by Reconstruction

Beatriz Soares Domingues Polita et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Sensation of the breast skin and nipple-areolar complex (NAC) is commonly assumed to be diminished or completely absent following nipple-sparing mastectomy (NSM) with implant- or expander-based reconstruction. The purpose of this cohort study was to evaluate breast skin and NAC long-term touch pressure sensibility, from 1 month to 1 year, after NSM followed by reconstruction with an implant or expander, and patient quality of life (QoL), hypothesizing that sensibility may diminish with a small progressive return throughout the postoperative period. Materials and Methods: This was achieved by performing sensation tests using Semmes-Weinstein monofilaments (SWM) in nine predefined points of the breast and NAC, a two-point discrimination test (TPD) in the four quadrants of the breast, and QoL assessment using the BREAST-Q. We evaluated 42 patients in Pauls Stradiņš Clinical University Hospital, with a total of 66 breasts, who underwent NSM between 2021 and 2023, performing the breast sensation tests before surgery and postoperatively at 1/3/6 months and 1 year. The BREAST-Q was administered to assess patient satisfaction and well-being. Results: Our results reflect a decline in breast skin and NAC sensation in the 1-month evaluation after NSM (mean: 4.67) when compared to the assessment before surgery (mean: 2.57), with a small progressive return reflected in the 3 months (mean: 3.79), 6 months (mean: 3.68), and 1-year evaluations (mean: 3.14). The following were the mean scores obtained from the BREAST-Q: Psychosocial Well-being (mean: 66), Sexual Well-being (mean: 50), Satisfaction with Breasts Pre-OP (mean: 58), satisfaction with breast reconstruction (mean: 52), Satisfaction with Implants, Satisfaction with nipple reconstruction, Physical Well-being Chest, Adverse effects of radiation, and Satisfaction with Information. Conclusions: This study confirms that sensibility diminishes after this procedure, as observed when comparing the sensation evaluation results before the operation with the 1-month evaluation, reflecting a small progressive return in the following months.

Keywords: BREAST-Q; breast reconstruction; nipple-sparing mastectomy; quality of life; sensation preservation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Nine predefined points for sensation evaluation of the breast skin and NAC.
Figure 2
Figure 2
Trend of average sensation values over time.
Figure 3
Figure 3
Trend of average sensation values for each predefined point over time.
See this image and copyright information in PMC

References

    1. Hammond J.B., Kandi L.A., Armstrong V.L., Kosiorek H.E., Rebecca A.M., Casey W.J., III, Kruger E.A., Cronin P.A., Pockaj B.A., Teven C.M. Long-term breast and nipple sensation after nipple-sparing mastectomy with implant reconstruction: Relevance to physical, psychosocial, and sexual well-being. J. Plast. Reconstr. Aesthetic Surg. 2022;75:2914–2919. doi: 10.1016/j.bjps.2022.06.034. - DOI - PubMed
    1. Dossett L.A., Lowe J., Sun W., Lee M.C., Smith P.D., Jacobsen P.B., Laronga C. Prospective evaluation of skin and nipple-areola sensation and patient satisfaction after nipple-sparing mastectomy. J. Surg. Oncol. 2016;114:11–16. doi: 10.1002/jso.24264. - DOI - PMC - PubMed
    1. Tsangaris E., Klassen A.F., Kaur M.N., Voineskos S., Bordeleau L., Zhong T., Broyles J., Pusic A.L. Development and Psychometric Validation of the BREAST-Q Sensation Module for Women Undergoing Post-Mastectomy Breast Reconstruction. Ann. Surg. Oncol. 2021;28:7842–7853. doi: 10.1245/s10434-021-10094-y. - DOI - PubMed
    1. Peled A.W., Amara D., Piper M.L., Klassen A.F., Tsangaris E., Pusic A.L. Development and Validation of a Nipple-Specific Scale for the BREAST-Q to Assess Patient-Reported Outcomes following Nipple-Sparing Mastectomy. Plast. Reconstr. Surg. 2019;143:1010–1017. doi: 10.1097/PRS.0000000000005426. - DOI - PubMed
    1. Chen C.M., Disa J.J., Sacchini V., Pusic A.L., Mehrara B.J., Garcia-Etienne C.A., Cordeiro P.G. Nipple-sparing mastectomy and immediate tissue expander/implant breast reconstruction. Plast. Reconstr. Surg. 2009;124:1772–1780. doi: 10.1097/PRS.0b013e3181bd05fd. - DOI - PubMed

LinkOut - more resources