Normal Cutaneous Sensibility of the Breast

Abstract

A total of 150 healthy women were studied to determine normal values for breast sensibility and to investigate the influence of breast size and ptosis on breast sensation. Cutaneous pressure thresholds were evaluated bilaterally in six areas including the nipple, the areola, and the skin of the breast using the Semmes-Weinstein monofilaments. We found that the skin of the superior quadrant was the most sensitive part of the breast, the areola was less sensitive, and the nipple was the least sensitive part. The cutaneous sensibility of all tested areas decreased significantly with increasing breast size and increasing breast ptosis. The nipple was less sensitive in women who had a previous pregnancy. Age, smoking history, or hormonal contraception had no significant influence on breast sensation. The study shows that the Semmes-Weinstein test is an adequate method for assessing sensation in the breast.

Nipple–areola complex cutaneous sensitivity: A systematic approach to classification and breast volume

“…7 Before Dellon's observation, Tairych et al had already attempted to produce normative data on breast and NAC sensitivity thresholds on a large series of 300 breasts in 150 healthy women, observing that larger breasts are significantly less sensitive than smaller ones and that increasing breast ptosis correlates with a significant decrease in sensibility. 5 Although their results are in line with the pertaining literature, 4,8e11 the utilization of SWM with their inherent limitations about wear and recalibration of the filaments and about statistical managing of data impairs the accuracy and reproducibility of the study and of the normative data thereby collected. In addition, authors only discuss the difference in sensitivity among the groups in a descriptive way, without providing a ratio that analytically explains such differences and the actual relationship among the different groups.…”

“…4,5,7 Gonzales et al have measured preoperative and postoperative pressure thresholds in a series of 84 breasts (43 patients), showing that nippleeareola sensibility was retained after operation in 90.5% of breasts, with a trend of decreasing nippleeareola sensibility with increasing breast size. 4 Likewise, Tairych et al have investigated the relationship among breast size, ptosis, and breast sensation in a large series of 300 breasts in 150 healthy women, showing that larger breasts are significantly less sensitive than smaller ones and that increasing breast ptosis correlates with a significant decrease in sensibility.…”

“…4 Likewise, Tairych et al have investigated the relationship among breast size, ptosis, and breast sensation in a large series of 300 breasts in 150 healthy women, showing that larger breasts are significantly less sensitive than smaller ones and that increasing breast ptosis correlates with a significant decrease in sensibility. 5 Perhaps this was due to the increased gravitational force on hypertrophic heavier breasts producing a stretch-type traction injury to the intercostal nerves. 4,8e10 For instance, the correction of the traction injury by means of breast reduction will not impair breast sensation, which instead is conserved or even increased.…”

The effect of superior pedicle breast reductions on breast sensation

“…Other authors have postulated that large and heavy breasts produce a chronic nerve traction injury as a possible cause for the inverse relationship. This relationship was confirmed in a study to quantify the normal cutaneous sensitivity of the breast by Semmes-Weinstein filaments [16]. The highest values in women with "gigantomastia" (bra size D or greater) were recorded by Slezak and Dellon [17] with values from 34 to 44 g/mm 2 (loss of protective sensation) although the mean sternal notch to nipple distance was comparable to our group (29 vs. 28 cm in our group) indicating a very high interrater variability.…”

“…To maintain as homologous patient groups as possible (large breasts are deemed significantly less sensitive to pressure [16,17]), women with a resection weight below and beyond 500 g per side were evaluated separately.…”