A Comparative Analysis of Sensory Return in Delayed-Immediate Versus Immediate Neurotized Deep Inferior Epigastric Perforator Flap Breast Reconstruction

Wang, Marcos Lu; Qin, Nancy; Chen, Yunchan; Freitas, Daniella De; Huang, Hao; Ellison, Angela M.; Otterburn, David M.

doi:10.1097/sap.0000000000003533

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Most recently, Djohan et al reported outcomes from a large case-control study looking at neurotization with nerve allografts in combination with nerve conduits during abdominally based free flap reconstruction, with significantly improved sensation seen at 1-year follow-up in the neurotized cohort ( 34 ). Another large study assessing delayed-immediate reconstruction with neurotized DIEP flaps showed return to baseline sensation in nearly all quadrants of the breast at 2-year follow-up ( 35 ). Although there is certainly a learning curve in performing flap neurotization as with any procedure, in the hands of experienced microsurgeons the additional operative time for performing neurotization is minimal ( 36 ).…”

Section: Immediate Sensory Nerve Reconstruction: Technique and Outcomesmentioning

confidence: 99%

Sensate immediate breast reconstruction

Peled,

Peled

2024

Gland Surg

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As breast cancer therapies and associated oncologic outcomes continue to improve, greater attention has been placed on quality-of-life issues after breast cancer and breast cancer risk-reducing treatments. The loss of sensation that typically occurs after mastectomy can have significant negative psychological, sexual, and functional impact on patients after surgery. Further, injury of nerves not only leads to numbness, but can also cause chronic neuropathic pain, which can be very debilitating to affected patients. In order to minimize these impacts, there is expanding uptake of surgical approaches that preserve nerves at the time of mastectomy and reconstruct injured nerves either during mastectomy or during delayed reconstruction. These advances have been facilitated by anatomic studies investigating different variants of intercostal anatomy and better understanding the course of the nerves innervating the mastectomy skin and nipple-areolar complex (NAC). With improved knowledge of the intercostal nerve anatomy, surgeons are able to carefully preserve nerves at the time of mastectomy, thus improving sensory outcomes. Additionally, nerve reconstruction techniques have advanced, particularly with newer nerve allograft technologies, which allows for nerve reconstruction to be done both at the time of mastectomy, as well as in a delayed fashion. The focus of this article is to describe the current state of sensory preservation and immediate reinnervation at the time of mastectomy and the advances that have allowed for these new approaches.

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Section: Immediate Sensory Nerve Reconstruction: Technique and Outcomesmentioning

confidence: 99%

Sensate immediate breast reconstruction

Peled,

Peled

2024

Gland Surg

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“…With great interest, we have read the article by Lu Wang et al 1 comparing sensory return between delayed-immediate and immediate neurotized deep inferior epigastric artery perforator (DIEP) flap breast reconstructions. The mounting evidence on breast sensation after breast reconstruction, especially autologous breast reconstruction, emphasizes its relevance and is an important development in the journey toward further increasing breast-related quality of life and improving outcomes after breast reconstruction.…”

mentioning

confidence: 99%

Letter to the Editor per Lu Wang et al.

van Rooij,

Tuinder

2024

Ann Plast Surg

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Importance of Breast Sensation After Mastectomy: Evidence from Three Sources

Lindau,

Pinkerton,

Abramsohn

et al. 2023

Women's Health Reports

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Background: Every year, more than 90,000 U.S. women undergo mastectomy. More than 40% have reconstruction. Following reconstruction, most women experience persistent partial or complete numbness of the reconstructed breasts, and many experience pain. Yet, breast reconstruction procedures focus largely on esthetic outcomes with mixed impact on sensory outcomes and little attention to pain. This study examines whether and how breast sensation is important to women. Materials and Methods: Conventional content analysis of extant qualitative data from a clinical registry (29 women with prior breast surgery for cancer, 2008–2022), a volunteer community sample (qualitative interviews with 6 women with and 5 without breast cancer, 2019), and from a Twitter social media survey ( N = 32, 2022). Results: Functions of the breast identified by women with and without cancer include breastfeeding, sexual function, and femininity. Five interrelated themes on the importance of breast sensation emerged among women with breast cancer history: sexual function, experience of partnered sex or relationship with one's sexual partner, breast embodiment, effect of breast pain on sexual function, and importance to psychological wellbeing. Women, advocates, and clinicians described a lack of patient–physician communication in this domain that exacerbates the negative impact of breast sensation loss on health and wellbeing. Conclusions: Breast sensation is important to women following mastectomy, yet a gap exists in patient–physician communication about the impact of mastectomy and reconstruction on breast sensory function. Lessons for physicians, scientists, and skeptics are conveyed about why the basic integrity of women's bodies matters for practice and science.

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A Comparative Analysis of Sensory Return in Delayed-Immediate Versus Immediate Neurotized Deep Inferior Epigastric Perforator Flap Breast Reconstruction

Cited by 3 publications

References 27 publications

Sensate immediate breast reconstruction

Sensate immediate breast reconstruction

Letter to the Editor per Lu Wang et al.

Importance of Breast Sensation After Mastectomy: Evidence from Three Sources

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