Top

Published in:

01-12-2009 | Brief Report

Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality?

Authors: F. Didier, D. Radice, S. Gandini, R. Bedolis, N. Rotmensz, A. Maldifassi, B. Santillo, A. Luini, V. Galimberti, E. Scaffidi, F. Lupo, S. Martella, J. Y. Petit

Published in: Breast Cancer Research and Treatment | Issue 3/2009

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.

Available only for authorised users

Fisher B, Andersen S, Bryant J, Margolese RG, Deutsh M, Fisher ER, Jeong JH, Wolmark N (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347(16):1233–1241. doi:10.1056/NEJMoa022152 CrossRefPubMed

Veronesi U, Salvadori B, Luini A, Banfi A, Zucali R, DelVecchio M, Saccozzi R, Beretta E, Boracchi P, Farante G (1990) Conservative treatment of early breast cancer: long term results of 1232 cases treated with quadrantectomy, axillary dissection and radiotherapy. Ann Surg 211:250–258PubMed

Andersen BL (1985) Sexual functioning morbidity among cancer survivors, current status and future research directions. Cancer 55:1835–1842. doi:10.1002/1097-0142(19850415)55:8<1835::AID-CNCR2820550832>3.0.CO;2-KCrossRefPubMed

Derogatis LR (1979) Breast and gynaecological cancers: their unique impact on body image and sexual identity in women. Front Radiat Ther Oncol 14:1–11PubMed

Hopwood P, Maguire P (1988) Body image problems in cancer patients. Br J Psychiatry Suppl. Jul;(2):47–50

Al-Ghazal SK, Fallowfield L, Blamey RW (1999) Does cosmetic outcomes from treatment of primary breast cancer influence psychosocial morbidity? Eur J Surg Oncol 25(6):571–573. doi:10.1053/ejso.1999.0708 CrossRefPubMed

Schain W (1985) Breast cancer surgeries and psychosexual sequelae: implications for remediation. Semin Oncol Nurs 1:200–205. doi:10.1016/S0749-2081(85)80009-7 CrossRefPubMed

Schover LR, Yetman RJ, Tuason LJ (1995) Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image and sexuality. Cancer 75(1):54–64. doi:10.1002/1097-0142(19950101)75:1<54::AID-CNCR2820750111>3.0.CO;2-ICrossRefPubMed

Schover LR (1991) The impact of breast cancer on sexuality, body image and intimate relationships. Cancer J Clin 41:112–120CrossRef

10.

Al-Ghazal SK, Fallowfield L, Blamey RW (2000) Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction. Eur J Cancer 36(15):1938–1943. doi:10.1016/S0959-8049(00)00197-0 CrossRefPubMed

11.

Al-Ghazal SK, Sully L, Fallowfield L, Blamey RW (2000) The psychological impact of immediate rather than delayed breast reconstruction. Eur J Surg Oncol 26:17–19. doi:10.1053/ejso.1999.0733 CrossRefPubMed

12.

Petit JY, Veronesi U, Orecchia R, Rey P, Didier F, Giraldo A, Luini A, De Lorenzi F, Rietjens M, Garusi C, Intra M, Yamaguchi S, Martella S (2003) The nipple-sparing mastectomy : early results of a feasibility study of a new application of perioperative radiotherapy (ELIOT) in the treatment of breast cancer when mastectomy is indicated. Tumori 89:288–291PubMed

13.

Petit JY, Veronesi U, Luini A, Orecchia A, Rey PC, Martella S, Didier F, De Lorenzi F, Rietjens M, Garusi C, Galimberti VE, Leida E, Lazzari R, Giraldo A (2005) When mastectomy becomes inevitable: the nipple-sparing approach. Breast 14:527–531. doi:10.1016/j.breast.2005.08.028 CrossRefPubMed

14.

Petit JY, Veronesi U, Orecchia A, Luini A, Rey Rojas AI, Intra M, Didier F, Martella S, Rietjens M, Garusi C, De Lorenzi F, Gatti G, Leon ME, Casadio C (2006) Nipple-sparing mastectomy in association with intra operative radiotherapy (ELIOT): a new type of mastectomy for breast cancer treatment. Breast Cancer Res Treat 96(1):47–51. doi:10.1007/s10549-005-9033-7 CrossRefPubMed

15.

Wellish DK, Schain WS, Barett Noone R, Little JW (1987) The psychological contribution of nipple addition in breast reconstruction. Plast Reconstr Surg Nov 80(5):699–704CrossRef

16.

Hopwood P, Fletcher I, Lee A, Al Ghazal S (2001) A body image scale for use with cancer patients. Eur J Cancer 37:189–197. doi:10.1016/S0959-8049(00)00353-1 CrossRefPubMed

17.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174. doi:10.2307/2529310 CrossRefPubMed

18.

Sanger CK, Reznikoff M (1981) Comparison of the psychological effects of breast-saving procedures with the modified radical mastectomy. Cancer 48:2341–2346. doi:10.1002/1097-0142(19811115)48:10<2341::AID-CNCR2820481034>3.0.CO;2-3CrossRefPubMed

19.

Polivy J (1977) Psychological effects of mastectomy on a woman’s feminine self-concept. J Nerv Ment Dis 164:77–87. doi:10.1097/00005053-197702000-00001 PubMedCrossRef

20.

Nano MT, Gill PG, Kollias J et al (2005) Psychological impact and cosmetic outcome of surgical breast cancer strategies. ANZ J Surg 75(11):940–947CrossRefPubMed

21.

Schain WS, D’Angelo TM, Dunn ME, Lichter AS, Pierce LJ (1994) Mastectomy versus conservative surgery and radiation therapy. Psychosocial consequences. Cancer 73(4):1221–1228. doi:10.1002/1097-0142(19940215)73:4<1221::AID-CNCR2820730416>3.0.CO;2-SCrossRefPubMed

22.

Sacchini V, Pinotti JA, Barros AC, Luini A, Pluchinotta A, Pinotti M, Boratto MG, Ricci MD, Ruiz CA, Nisida AC, Veronesi P, Petit JY, Arnone P, Bassi F, Disa JJ, Garcia-Etienne CA, Borgen PI (2006) Nipple-sparing mastectomy for breast cancer and risk reduction: oncologic or technical problem?. J Am Coll Surg 203(5):704–714. doi:10.1016/j.jamcollsurg.2006.07.015 CrossRefPubMed

23.

Banerjee A, Gupta S, Bhattacharya N (2008) Preservation of nipple-areola complex in breast cancer- a clinicopathological assessment. J Plast Reconstr Aesthet Surg 61(10):1195–1198. doi:10.1016/j.bjps.2007.08.005 CrossRefPubMed

24.

Ueda S, Tamaki Y, Yano K, Okishiro N, Yanagisawa T, Imasato M, Shimazu K, Kim SJ, Miyoshi Y, Tanji Y, Taguchi T, Noguchi S (2008) Cosmetic outcome and patient satisfaction after skin-sparing mastectomy for breast cancer with immediate reconstruction of the breast. Surgery 143(3):414–425. doi:10.1016/j.surg.2007.10.006 CrossRefPubMed

25.

Chung AP, Sacchini V (2008) Nipple-sparing mastectomy: where are we now? Surg Oncol 17(4):261–266. doi:j.suronc.2008.03.004 CrossRefPubMed

Title: Does nipple preservation in mastectomy improve satisfaction with cosmetic results, psychological adjustment, body image and sexuality?
Authors: F. Didier
D. Radice
S. Gandini
R. Bedolis
N. Rotmensz
A. Maldifassi
B. Santillo
A. Luini
V. Galimberti
E. Scaffidi
F. Lupo
S. Martella
J. Y. Petit
Publication date: 01-12-2009
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2009
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-008-0238-4

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 3/2009

Caution regarding genotyping methodology for a tri-allelic polymorphism in the novel breast cancer susceptibility gene NQO2

Correlation of HER2 status between primary tumors and corresponding circulating tumor cells in advanced breast cancer patients

The immunohistochemically “ER-negative, PR-negative, HER2-negative, CK5/6-negative, and HER1-negative” subgroup is not a surrogate for the normal-like subtype in breast cancer

Reporting of race and ethnicity in breast cancer research: room for improvement

Stimulation of the bradykinin B1 receptor induces the proliferation of estrogen-sensitive breast cancer cells and activates the ERK1/2 signaling pathway

STK15 F31I polymorphism is associated with breast cancer risk: a meta-analysis involving 25,014 subjects

Keynote webinar | Spotlight on antibody–drug conjugates in cancer