BACKGROUND: Loss of the nipple-areola complex can be psychologically and sexually devastating. Nipple-sparing mastectomy provides robust cosmetic results, but few studies have investigated the quality-of-life outcomes associated with it. METHODS: The authors performed an institutional review board-approved retrospective study of 32 patients who underwent nipple-sparing mastectomy with implant-based or autologous reconstruction and 32 control patients who underwent non-nipple-sparing mastectomy with reconstruction matched by reconstruction type and operative period. They then compared premastectomy and postreconstruction responses to the BREAST-Q, a validated and breast reconstruction-specific quality-of-life questionnaire, within and between their study and control populations. RESULTS: The nipple-sparing and non-nipple-sparing mastectomy groups were statistically similar in terms of mean age [49.9 ± 8.5 years (range, 36 to 69 years) and 47.7 ± 10.3 years (range, 26 to 68 years) (p = 0.29), respectively] and mean body mass index [24.3 ± 3.5 kg/m (range, 17.9 to 33.7 kg/m) and 25.5 ± 5.4 kg/m (range, 19.2 to 39.2 kg/m) (p = 0.29), respectively]. There were no significant between-group differences in occurrence of postreconstruction complications. The authors found significantly higher mean postreconstruction scores in the nipple-sparing mastectomy group within the Satisfaction with Breasts (p = 0.039) and the Satisfaction with Outcome (p = 0.017) domains. Finally, they noted higher median postreconstruction scores in the nipple-sparing mastectomy group within the Psychosocial Well-being (p = 0.043) and Satisfaction with Breasts (p = 0.004) domains. CONCLUSIONS: Psychological concerns regarding malignancy may negatively impact premastectomy patient quality of life. Reconstructive surgery improves patients' postmastectomy quality of life. Nipple-sparing mastectomy appears to provide significantly better improvement in postreconstruction quality of life, specifically in the Satisfaction with Breasts and Satisfaction with Outcome domains of the BREAST-Q, compared with non-nipple-sparing mastectomies. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
BACKGROUND: Loss of the nipple-areola complex can be psychologically and sexually devastating. Nipple-sparing mastectomy provides robust cosmetic results, but few studies have investigated the quality-of-life outcomes associated with it. METHODS: The authors performed an institutional review board-approved retrospective study of 32 patients who underwent nipple-sparing mastectomy with implant-based or autologous reconstruction and 32 control patients who underwent non-nipple-sparing mastectomy with reconstruction matched by reconstruction type and operative period. They then compared premastectomy and postreconstruction responses to the BREAST-Q, a validated and breast reconstruction-specific quality-of-life questionnaire, within and between their study and control populations. RESULTS: The nipple-sparing and non-nipple-sparing mastectomy groups were statistically similar in terms of mean age [49.9 ± 8.5 years (range, 36 to 69 years) and 47.7 ± 10.3 years (range, 26 to 68 years) (p = 0.29), respectively] and mean body mass index [24.3 ± 3.5 kg/m (range, 17.9 to 33.7 kg/m) and 25.5 ± 5.4 kg/m (range, 19.2 to 39.2 kg/m) (p = 0.29), respectively]. There were no significant between-group differences in occurrence of postreconstruction complications. The authors found significantly higher mean postreconstruction scores in the nipple-sparing mastectomy group within the Satisfaction with Breasts (p = 0.039) and the Satisfaction with Outcome (p = 0.017) domains. Finally, they noted higher median postreconstruction scores in the nipple-sparing mastectomy group within the Psychosocial Well-being (p = 0.043) and Satisfaction with Breasts (p = 0.004) domains. CONCLUSIONS: Psychological concerns regarding malignancy may negatively impact premastectomy patient quality of life. Reconstructive surgery improves patients' postmastectomy quality of life. Nipple-sparing mastectomy appears to provide significantly better improvement in postreconstruction quality of life, specifically in the Satisfaction with Breasts and Satisfaction with Outcome domains of the BREAST-Q, compared with non-nipple-sparing mastectomies. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
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Authors: Ida Oberhauser; Jasmin Zeindler; Mathilde Ritter; Jeremy Levy; Giacomo Montagna; Robert Mechera; Savas Deniz Soysal; Liliana Castrezana López; Veronica D'Amico; Elisabeth Artemis Kappos; Fabienne Dominique Schwab; Madleina Müller; Christian Kurzeder; Martin Haug; Walter Paul Weber Journal: Breast Care (Basel) Date: 2020-11-25 Impact factor: 2.860
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Authors: Walter P Weber; Martin Haug; Christian Kurzeder; Vesna Bjelic-Radisic; Rupert Koller; Roland Reitsamer; Florian Fitzal; Jorge Biazus; Fabricio Brenelli; Cicero Urban; Régis Resende Paulinelli; Jens-Uwe Blohmer; Jörg Heil; Jürgen Hoffmann; Zoltan Matrai; Giuseppe Catanuto; Viviana Galimberti; Oreste Gentilini; Mitchel Barry; Tal Hadar; Tanir M Allweis; Oded Olsha; Maria João Cardoso; Pedro F Gouveia; Isabel T Rubio; Jana de Boniface; Tor Svensjö; Susanne Bucher; Peter Dubsky; Jian Farhadi; Mathias K Fehr; Ilario Fulco; Ursula Ganz-Blättler; Andreas Günthert; Yves Harder; Nik Hauser; Elisabeth A Kappos; Michael Knauer; Julia Landin; Robert Mechera; Francesco Meani; Giacomo Montagna; Mathilde Ritter; Ramon Saccilotto; Fabienne D Schwab; Daniel Steffens; Christoph Tausch; Jasmin Zeindler; Savas D Soysal; Visnu Lohsiriwat; Tibor Kovacs; Anne Tansley; Lynda Wyld; Laszlo Romics; Mahmoud El-Tamer; Andrea L Pusic; Virgilio Sacchini; Michael Gnant Journal: Breast Cancer Res Treat Date: 2018-09-04 Impact factor: 4.872