title: Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality?
abstract: 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.
authors.affiliation: Psycho-Oncology Unit, Department of Medicine (Prof. A. Goldhirsch), European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy. Florence.didier@ieo.it
authors.forename: F
authors.initials: F
authors.lastname: Didier
authors.forename: D
authors.initials: D
authors.lastname: Radice
authors.forename: S
authors.initials: S
authors.lastname: Gandini
authors.forename: R
authors.initials: R
authors.lastname: Bedolis
authors.forename: N
authors.initials: N
authors.lastname: Rotmensz
authors.forename: A
authors.initials: A
authors.lastname: Maldifassi
authors.forename: B
authors.initials: B
authors.lastname: Santillo
authors.forename: A
authors.initials: A
authors.lastname: Luini
authors.forename: V
authors.initials: V
authors.lastname: Galimberti
authors.forename: E
authors.initials: E
authors.lastname: Scaffidi
authors.forename: F
authors.initials: F
authors.lastname: Lupo
authors.forename: S
authors.initials: S
authors.lastname: Martella
authors.forename: J Y
authors.initials: JY
authors.lastname: Petit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods* / Q000523:psychology*; D008875:Middle Aged; D009558:Nipples / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D019651:Plastic Surgery Procedures / Q000379:methods / Q000523:psychology; D019529:Sexuality / Q000523:psychology; D011795:Surveys and Questionnaires