Patient satisfaction with nipple-sparing mastectomy: A prospective study of patient reported outcomes using the BREAST-Q

Abstract

Background and Objectives The authors sought to study patient-reported outcomes following nipple-sparing mastectomy (NSM). Methods From 2008 to 2011, the BREAST-Q was administered to women undergoing NSM surgery for cancer treatment or risk-reduction prior to surgery and at two years after completion of reconstruction. The change in score over time and the impact of surgical indication, complication occurrence and laterality on scores were analyzed. Results The BREAST-Q was prospectively administered to 39 women undergoing NSM for cancer treatment (n=17) or risk-reduction (RR) (n =22). At two years after operation, median overall satisfaction with breasts was 75 (IQR=67,100). There were significant postoperative increases in scores for overall satisfaction with breasts (+8, p=0.021) and psychosocial well-being (+14, p=0.003). Postoperatively, RR patients had significantly higher scores for psychosocial wellness, physical impact (chest), and overall satisfaction with outcome compared to cancer treatment patients (p<0.05). Also, increase from preoperative to postoperative psychosocial wellness was higher in the RR compared to cancer treatment patients (+17 vs. +1, p=.043). Complication occurrence did not significantly impact postoperative scores. Conclusions Following NSM for cancer treatment or RR, patients demonstrated high levels of satisfaction and quality of life as measured by BREAST-Q. Satisfaction level increased two years following operation.

Quality of life and sexual well‐being after nipple sparing mastectomy: A matched comparison of patients using the breast Q

“…Our NSM patients found that they were more likely to feel sexually attractive and fulfilled as compared to those patients undergoing SSM. Previous studies that examined these domains after NSM have found comparable raw BREAST‐Q scores . Raw scores for psychosocial well being ranged from 83.2‐86, satisfaction with breast from 66.2‐73 and sexual well being raw score ranged from 57 to 65.5 .…”

“…There are other studies that have examined NSM patients using the BREAST‐Q . While these studies have found similar results for the NSM patients in the patient reported outcomes, there has been variability in the study designs.…”

“…Preservation of the nipple areolar complex (NAC) has an aesthetic advantage for mastectomy patients and therefore nipple sparing mastectomy (NSM) has gained popularity in recent years. Multiple studies have reported similar recurrence rates and survival outcomes for NSM patients compared to those who have undergone skin sparing mastectomy (SSM) . However, the literature exploring the psychosocial benefits of nipple‐sparing mastectomy is conflicting …”

“…The surgical management of breast cancer (BC) has drastically evolved from the days of the Halsted mastectomy as surgeons have endeavored to provide oncologically safe procedures while improving cosmetic outcomes. 1 Preservation of the nipple areolar complex (NAC) has an aesthetic advantage for mastectomy patients and therefore nipple sparing mastectomy (NSM) has gained popularity in | 3 239 recent years. Multiple studies have reported similar recurrence rates and survival outcomes for NSM patients compared to those who have undergone skin sparing mastectomy (SSM).…”

“…Multiple studies have reported similar recurrence rates and survival outcomes for NSM patients compared to those who have undergone skin sparing mastectomy (SSM). 1,2 However, the literature exploring the psychosocial benefits of nipple-sparing mastectomy is conflicting. 1,[3][4][5] In recent years, there has been an increased emphasis on quality of life (QOL) and psychosocial outcomes of BC patients, particularly in the setting of patient reported outcomes.…”