Open AccessPsychosocial and Sexual Well‐Being Following Nipple‐Sparing Mastectomy and Reconstruction
Author(s) -
Wei Cindy H.,
Scott Amie M.,
Price Alison N.,
Miller Helen Catherine,
Klassen Anne F.,
Jhanwar Sabrina M.,
Mehrara Babak J.,
Disa Joseph J.,
McCarthy Colleen,
Matros Evan,
Cordeiro Peter G.,
Sacchini Virgilio,
Pusic Andrea L.
Publication year - 2016
Publication title -
the breast journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.533
H-Index - 72
eISSN - 1524-4741
pISSN - 1075-122X
DOI - 10.1111/tbj.12542
Subject(s) - medicine , breast reconstruction , psychosocial , mastectomy , patient satisfaction , quality of life (healthcare) , breast cancer , surgery , multivariate analysis , implant , confounding , cancer , nursing , psychiatry
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.