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01-10-2017 | Breast Oncology

Prospective Study Comparing Surgeons’ Pain and Fatigue Associated with Nipple-Sparing versus Skin-Sparing Mastectomy

Authors: Rubie Sue Jackson, MD, MPH, Thomas Sanders, PhD, Adrian Park, MD, Robert Buras, MD, Wen Liang, DO, Christine Harris, MD, Charles Mylander, PhD, Martin Rosman, MD, Luther Holton, MD, Devinder Singh, MD, Laura Martino, BS, Lorraine Tafra, MD

Published in: Annals of Surgical Oncology | Issue 10/2017

Abstract

Background

Nipple-sparing mastectomy (NSM) is more technically challenging than skin-sparing mastectomy (SSM) but offers quality-of-life and cosmetic advantages. However, surgeon physical symptoms related to NSM workload have not been documented.

Methods

This was a prospective study using questionnaires to compare surgeon-reported physical symptoms before, during, and after NSM versus SSM. Surgeons also answered general questions about each mastectomy. Bilateral cases were performed simultaneously by two surgeons, who completed independent questionnaires.

Results

Questionnaires were completed after 82 SSMs and 44 NSMs. On a 0–10 scale, surgeons reported NSM was more physically demanding than SSM (7.0 vs. 4.5, p < 0.001). Mean visualization was more difficult (5.7 vs. 3.2, p < 0.001) and mean fatigue score was greater (5.6 vs. 3.1, p < 0.001) after NSM than SSM. The mean increase in neck pain (on a 0–4 scale) was greater for NSM than SSM, both from before-to-during surgery (0.8 vs. 0.2, p = 0.003) and before-to-after surgery (0.9 vs. 0.2, p = 0.002). The mean increase in lower back pain was greater for NSM than SSM, both from before-to-during surgery (0.7 vs. 0.2, p = 0.008) and before-to-after surgery (0.9 vs. 0.2, p = 0.003). Surgeons reported that NSM was more mentally demanding (p < 0.001), complex (p = 0.01), and difficult (p < 0.001) than SSM.

Conclusion

Surgeons experienced greater physical symptoms, mental strain, and fatigue with NSM than SSM. This raises concern that mild but repetitive pain over the course of a breast surgeon’s career may lead to repetitive stress injury.

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Title: Prospective Study Comparing Surgeons’ Pain and Fatigue Associated with Nipple-Sparing versus Skin-Sparing Mastectomy
Authors: Rubie Sue Jackson, MD, MPH
Thomas Sanders, PhD
Adrian Park, MD
Robert Buras, MD
Wen Liang, DO
Christine Harris, MD
Charles Mylander, PhD
Martin Rosman, MD
Luther Holton, MD
Devinder Singh, MD
Laura Martino, BS
Lorraine Tafra, MD
Publication date: 01-10-2017
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 10/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-017-5929-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prospective Study Comparing Surgeons’ Pain and Fatigue Associated with Nipple-Sparing versus Skin-Sparing Mastectomy

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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