Psychosocial and sexual well-being following nipple-sparing mastectomy and reconstruction Journal Article

Authors: Wei, C. H.; Scott, A. M.; Price, A. N.; Miller, H. C.; Klassen, A. F.; Jhanwar, S. M.; Mehrara, B. J.; Disa, J. J.; McCarthy, C.; Matros, E.; Cordeiro, P. G.; Sacchini, V.; Pusic, A. L.
Article Title: Psychosocial and sexual well-being following nipple-sparing mastectomy and reconstruction
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. © 2015 Wiley Periodicals, Inc.
Keywords: breast reconstruction; health-related quality of life; nipple-sparing mastectomy; implant reconstruction; breast-q
Journal Title: Breast Journal
Volume: 22
Issue: 1
ISSN: 1075-122X
Publisher: Wiley Blackwell  
Date Published: 2016-01-01
Start Page: 10
End Page: 17
Language: English
DOI: 10.1111/tbj.12542
PROVIDER: scopus
PUBMED: 26782950
PMCID: PMC4843778
Notes: Article -- Export Date: 3 March 2016 -- Source: Scopus
Citation Impact
MSK Authors
  1. Joseph Disa
    241 Disa
  2. Andrea Pusic
    299 Pusic
  3. Virgilio Sacchini
    141 Sacchini
  4. Babak Mehrara
    360 Mehrara
  5. Peter G Cordeiro
    266 Cordeiro
  6. Evan Matros
    146 Matros
  7. Sabrina M Jhanwar
    17 Jhanwar
  8. Amie Marie Scott
    45 Scott
  9. Colleen Marie McCarthy
    125 McCarthy
  10. Alison Nicole Price
    4 Price
  11. Cindy Hsin-Yao Wei
    1 Wei