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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 study was to evaluate breast skin and NAC long-term touch pressure sensibility, 1 month to 1 year, after NSM followed by reconstruction and patient quality of life (QoL). This was achieved by performing sensation tests using Semmes-Weinstein monofilaments (SWM) in nine pre-defined points of the breast and NAC, a 2-point discrimination test (TPD) in the four quadrants of the breast, and QoL assessment using the BREAST-Q. We have evaluated 41 patients in Pauls Stradiņš Clinical University Hospital, with a total of 65 breasts, who underwent NSM between 2021 and 2023, performing the breast sensation tests before surgery, and postoperatively 1/3/6 months, and 1 year. Inclusion criteria included patients who had undergone NSM followed by reconstruction with an implant or expander, no excision of the nipple, ability to provide written consent, ability to answer the questionnaire, and age over 18 years. The exclusion criteria were as follows: sensitivity examination could not be performed, different surgical techniques other than nipple- sparing mastectomy, if the nipple was excised, if the patient did not meet the inclusion criteria. Our results reflect a decline in breast skin and NAC sensation in the 1-month evaluation after NSM (Median: 4.74) when compared to the assessment before surgery (Median: 2.44), with a small progressive return reflected in the 3 months (Median: 4.08), 6 months (Median: 3.61), and 1-year evaluation. The following were the mean scores obtained from BREAST-Q: Psychosocial Well-being (Mean: 41, IQR: 38-49), Sexual Well-being (Mean: 19.79, IQR: 16-24), Satisfaction with Breasts Pre-OP (Mean: 12.21, IQR: 11-14), Satisfaction with breast reconstruction (Mean: 41.5, IQR: 38.5-50). This study confirmed 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.
Polita et al. (Wed,) studied this question.