Olano Austin, Chou John, Lampropoulos Emma, Aalberg Jeffrey, Jonczyk Michael, Nardello Salvatore, Persing Sarah, Chatterjee Abhishek
From the Division of Plastic and Reconstructive Surgery, Tufts Medical Center, Boston, MA.
Tufts University School of Medicine, Boston, MA.
Plast Reconstr Surg Glob Open. 2025 Mar 31;13(3):e6603. doi: 10.1097/GOX.0000000000006603. eCollection 2025 Mar.
Oncoplastic breast surgery (OBS) is a form of breast conservation surgery that integrates cancer removal with the reconstruction of the breast and immediate contralateral symmetry surgery followed by adjuvant radiation. This study aimed to identify differences in nipple-areolar complex (NAC) outcomes by comparing the oncological breast (which also receives adjuvant radiation) to the contralateral breast following OBS.
Interviews containing validated nipple-focused questions were conducted on 28 patients (encompassing 56 breasts) who had undergone OBS with immediate contralateral symmetry surgery followed by adjuvant radiation. Outcomes were ranked on Likert scales. A Wilcoxon signed-rank test was used to analyze the results for differences in rankings between the oncological breast and the contralateral symmetry breast.
There were no statistically significant differences in patient satisfaction with nipple height or NAC shape when comparing breasts having undergone oncological resection versus symmetry surgery. A majority of patients reported being satisfied with the look of the NAC on the oncological breast. There was less reported nipple sensation on the oncological breast compared with the symmetry breast; however, there was no statistically significant difference in patient satisfaction with nipple sensation.
Nipple-areolar outcomes following OBS and adjuvant radiation are favorable in terms of patient sensation and appearance particularly when compared with the contralateral breast undergoing symmetry reduction surgery. These findings can enhance the preoperative counseling of patients in the breast cancer surgical decision-making process.
肿瘤整形乳房手术（OBS）是一种保乳手术形式，它将癌症切除与乳房重建以及即刻对侧对称手术相结合，随后进行辅助放疗。本研究旨在通过比较肿瘤整形乳房（也接受辅助放疗）与OBS术后对侧乳房的乳头乳晕复合体（NAC）结果，来确定两者之间的差异。
对28例患者（共56个乳房）进行了访谈，这些患者接受了OBS并即刻进行对侧对称手术，随后接受辅助放疗。访谈中包含经过验证的聚焦乳头的问题。结果采用李克特量表进行排名。使用Wilcoxon符号秩检验分析肿瘤整形乳房与对侧对称乳房在排名上的差异结果。
比较接受肿瘤切除手术的乳房与接受对称手术的乳房时，患者对乳头高度或NAC形状的满意度没有统计学上的显著差异。大多数患者表示对肿瘤整形乳房上NAC的外观感到满意。与对称乳房相比，肿瘤整形乳房上报告的乳头感觉较少；然而，患者对乳头感觉的满意度没有统计学上的显著差异。
OBS和辅助放疗后的乳头乳晕结果在患者感觉和外观方面是良好的，特别是与接受对称缩小手术的对侧乳房相比。这些发现可以加强乳腺癌手术决策过程中患者的术前咨询。
