Jagasia Puja M, Bagdady Kazimir, Jordan Sumanas W, Howard Michael A, Fracol Megan E
From the Division of Plastic Surgery, Northwestern Memorial Hospital, Chicago, IL.
Plast Reconstr Surg Glob Open. 2025 May 6;13(5):e6751. doi: 10.1097/GOX.0000000000006751. eCollection 2025 May.
Breast and nipple-areolar complex (NAC) sensation after breast reconstruction impacts postoperative quality of life. Autologous breast reconstruction (ABR) and implant-based breast reconstruction (IBBR) are standard techniques. Neurotization has shown promise in improving sensory outcomes.
A computerized search was conducted on March 20, 2024, using the following databases: PubMed (1994-2024), MEDLINE (1996-2024), Embase (1988-2024), Web of Science (1997-2024), Scopus (2004-2024), and CINAHL (1994-2024). The following terms were used: "Semmes-Weinstein" and "mastectomy" OR "Semmes-Weinstein" and "breast reconstruction." Studies that reported objective results from Semmes-Weinstein monofilament testing by breast and NAC quadrant at least 12 months postoperatively were included. Statistical analysis was performed using multivariate regression analysis incorporating variables that were found to be significant on univariate regression analysis. This was followed by pairwise comparisons using Tukey tests to directly compare ABR, IBBR, and ABR with neurotization.
Thirteen studies reporting on sensory outcomes of 764 reconstructed breasts met the aforementioned criteria. ABR with neurotization resulted in better sensation outcomes on the breast and NAC compared with either ABR or IBBR. When controlling for radiation, ABR without neurotization resulted in more sensate NAC region/central mound compared with IBBR. These findings suggest that ABR with neurotization following skin-sparing mastectomy results in better sensation at the new NAC compared with nipple-sparing mastectomy with ABR without neurotization.
ABR with neurotization may result in superior breast sensation, which is associated with increased quality of life and satisfaction, compared with ABR without neurotization and IBBR.
乳房重建术后乳房及乳头乳晕复合体（NAC）的感觉会影响术后生活质量。自体乳房重建（ABR）和植入式乳房重建（IBBR）是标准技术。神经移植在改善感觉结果方面已显示出前景。
于2024年3月20日进行计算机检索，使用以下数据库：PubMed（1994 - 2024年）、MEDLINE（1996 - 2024年）、Embase（1988 - 2024年）、科学网（1997 - 2024年）、Scopus（2004 - 2024年）和CINAHL（1994 - 2024年）。使用了以下检索词：“Semmes - Weinstein”和“乳房切除术”或“Semmes - Weinstein”和“乳房重建”。纳入术后至少12个月通过Semmes - Weinstein单丝测试按乳房和NAC象限报告客观结果的研究。采用多变量回归分析进行统计分析，纳入在单变量回归分析中被发现具有显著性的变量。随后使用Tukey检验进行成对比较，以直接比较ABR、IBBR以及进行了神经移植的ABR。
13项报告764例重建乳房感觉结果的研究符合上述标准。与ABR或IBBR相比，进行了神经移植的ABR在乳房和NAC上产生了更好的感觉结果。在控制放疗因素后，未进行神经移植的ABR与IBBR相比，NAC区域/中央隆起的感觉更敏锐。这些发现表明，与未进行神经移植的保留乳头乳房切除术联合ABR相比，保留皮肤乳房切除术后进行神经移植的ABR在新的NAC处产生更好的感觉。
与未进行神经移植的ABR和IBBR相比，进行了神经移植的ABR可能会带来更优的乳房感觉，这与生活质量和满意度的提高相关。
