Department of Surgery, Rīga Stradiņš University, LV-1007 Rīga, Latvia.
Pauls Stradiņš Clinical University Hospital, LV-1002 Rīga, Latvia.
Medicina (Kaunas). 2024 Oct 9;60(10):1655. doi: 10.3390/medicina60101655.
: 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 cohort study was to evaluate breast skin and NAC long-term touch pressure sensibility, from 1 month to 1 year, after NSM followed by reconstruction with an implant or expander, and patient quality of life (QoL), hypothesizing that sensibility may diminish with a small progressive return throughout the postoperative period. : This was achieved by performing sensation tests using Semmes-Weinstein monofilaments (SWM) in nine predefined points of the breast and NAC, a two-point discrimination test (TPD) in the four quadrants of the breast, and QoL assessment using the BREAST-Q. We evaluated 42 patients in Pauls Stradiņš Clinical University Hospital, with a total of 66 breasts, who underwent NSM between 2021 and 2023, performing the breast sensation tests before surgery and postoperatively at 1/3/6 months and 1 year. The BREAST-Q was administered to assess patient satisfaction and well-being. : Our results reflect a decline in breast skin and NAC sensation in the 1-month evaluation after NSM (mean: 4.67) when compared to the assessment before surgery (mean: 2.57), with a small progressive return reflected in the 3 months (mean: 3.79), 6 months (mean: 3.68), and 1-year evaluations (mean: 3.14). The following were the mean scores obtained from the BREAST-Q: Psychosocial Well-being (mean: 66), Sexual Well-being (mean: 50), Satisfaction with Breasts Pre-OP (mean: 58), satisfaction with breast reconstruction (mean: 52), Satisfaction with Implants, Satisfaction with nipple reconstruction, Physical Well-being Chest, Adverse effects of radiation, and Satisfaction with Information. : This study confirms 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.
乳房皮肤和乳晕乳头复合体(NAC)的感觉通常被认为在保留乳头的乳房切除术(NSM)后会减弱或完全消失,采用植入物或扩张器为基础的重建。本队列研究的目的是评估 NSM 后采用植入物或扩张器重建 1 个月至 1 年内乳房皮肤和 NAC 的长期触压感觉,假设敏感性可能会随着术后期间的逐渐恢复而逐渐降低。通过使用 Semmes-Weinstein 单丝(SWM)在乳房和 NAC 的九个预先定义的点进行感觉测试、在乳房的四个象限进行两点辨别测试(TPD)以及使用 BREAST-Q 进行生活质量(QoL)评估来实现这一目标。我们评估了 2021 年至 2023 年间在 Pauls Stradiņš 临床大学医院接受 NSM 的 42 名患者,共有 66 只乳房,在术前和术后 1/3/6 个月和 1 年进行乳房感觉测试。使用 BREAST-Q 评估患者满意度和幸福感。我们的结果反映了 NSM 后 1 个月评估时乳房皮肤和 NAC 感觉的下降(平均:4.67),与术前评估相比(平均:2.57),在 3 个月(平均:3.79)、6 个月(平均:3.68)和 1 年评估(平均:3.14)时逐渐恢复。从 BREAST-Q 获得的平均分数如下:心理幸福感(平均:66)、性健康(平均:50)、乳房术前满意度(平均:58)、乳房重建满意度(平均:52)、对植入物的满意度、乳头重建满意度、胸部生理健康、放射治疗的不良影响和信息满意度。这项研究证实,手术后敏感性会降低,如与手术前的感觉评估结果相比,1 个月的评估结果反映了随后几个月的逐渐恢复。