Psycho-Oncology Unit, Department of Medicine (Prof. A. Goldhirsch), European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
Breast Cancer Res Treat. 2009 Dec;118(3):623-33. doi: 10.1007/s10549-008-0238-4. Epub 2008 Nov 12.
We investigated the influence of nipple areolar complex (NAC) sparing in mastectomy, on patient satisfaction with cosmetic results, body-image, sexuality and psychological well-being. We developed a specific questionnaire and compared two groups of women who underwent radical mastectomy with immediate breast reconstruction (IBR). Between 2004 and 2006, 310 women with NAC preservation and 143 patients with successive NAC reconstruction were mailed the questionnaire at follow-up 1 year after definitive complete breast reconstruction surgery. 256 questionnaires was available. Our results showed significant differences in favour of the NAC sparing group regarding body image (difficulty in looking at themselves naked and being seen naked by their partners after surgery, P = 0.001 and P = 0.003, respectively); regarding satisfaction with the appearance of the nipple (P < .0001) and with the sensitivity of the nipple (P = 0.001); regarding the feeling of mutilation (P = 0.003). NAC sparing in mastectomy has a positive impact on patient satisfaction, body image and psychological adjustment.
我们研究了乳房切除术时保留乳头乳晕复合体（NAC）对患者对美容效果、身体形象、性生活和心理健康满意度的影响。我们开发了一种专门的问卷，并比较了两组接受根治性乳房切除术和即刻乳房重建（IBR）的女性。2004 年至 2006 年，在确定性完全乳房重建手术后 1 年的随访中，向 310 名保留 NAC 的女性和 143 名连续 NAC 重建的患者邮寄了问卷。共收到 256 份问卷。我们的结果表明，在身体形象方面（手术后难以裸体面对自己和伴侣，P = 0.001 和 P = 0.003），以及在乳头外观满意度（P <.0001）和乳头敏感性（P = 0.001）方面，NAC 保留组存在显著差异；在对畸形的感觉方面（P = 0.003）。乳房切除术时保留 NAC 对患者满意度、身体形象和心理调整有积极影响。
