The Psychological Contribution of Nipple Addition in Breast Reconstruction

Wellisch, David K.; Schain, Wendy S.; Noone, R. Barrett; Little, John W.

doi:10.1097/00006534-198711000-00007

Cited by 244 publications

(123 citation statements)

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“…There are very few studies assessing the impact of NAC reconstruction on breast reconstruction: e.g., we found only one specific article [15] that showed that NAC reconstruction had a positive impact on patient's satisfaction with cosmetic results. In our study, we wanted to understand the psychological contribution of nipple conservation versus nipple reconstruction comparing NSM versus mastectomy with breast and NAC reconstruction.…”

Section: Discussionmentioning

confidence: 97%

“…Results were published by Petit et al [12][13][14]. The effect of removal of the NAC during mastectomy and of nipple reconstruction procedures has not been often studied; Wellisch et al [15] demonstrated the positive psychological impact of NAC reconstruction after mastectomy and breast reconstruction when comparing patients with or without NAC reconstruction. We decided to further investigate the possible advantages of NAC preservation in mastectomy.…”

Section: Introductionmentioning

confidence: 99%

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

Didier

Radice

Gandini

et al. 2008

Breast Cancer Res Treat

257

128

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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.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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

Didier

Radice

Gandini

et al. 2008

Breast Cancer Res Treat

257

128

View full text Add to dashboard Cite

show abstract

“…However, despite the reconstruction, patients are often distressed by the sense of mutilation. The nipple-areola complex (NAC) is an identifying characteristic of the breast [12] and conserving it decreases the feeling of mutilation when the mastectomy is required. Several authors investigating the possibility of nipple-areola preservation have evaluated the risk of tumour involvement [13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Nipple sparing mastectomy with nipple areola intraoperative radiotherapy: one thousand and one cases of a five years experience at the European institute of oncology of Milan (EIO)

Veronesi²,

Orecchia

et al. 2009

Breast Cancer Res Treat

214

138

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In order to reduce mutilation, nipple-areola complex (NAC) conservation can be proposed for the treatment of breast cancer when mastectomy is indicated. To reduce the risk of retro areolar recurrence, a novel radiosurgical treatment combining subcutaneous mastectomy with intraoperative radiotherapy (ELIOT) is proposed. One thousand and one nipple sparing mastectomies (NSM) were performed from March 2002 to November 2007 at the European institute of oncology (EIO), for invasive carcinoma in 82% of the patients and in situ carcinoma in 18%.Clinical complications, aesthetic results, oncological and psychological results were recorded. A comparison was performed between the 800 patients who received ELIOT and the 201 who underwent delayed one-shot radiotherapy on the days following the operation. The median follow up time was 20 months (range 1-69) for a follow up performed in 83% of the patients. The NAC necrosed totally in 35 cases (3.5%) and partially in 55 (5.5%) and was removed in 50 (5%). Twenty infections (2%) were observed and 43 (4.3%) prostheses removed. The median rate of the patients for global cosmetic result on a scale ranging from 0 (worst) to 10 (excellent) was 8. Evaluation by the surgeon in charge of the follow-up gave a similar result. Only 15% of the patients reported a partial sensitivity of the NAC. Of the fourteen (1.4%) local recurrences, ten occurred close to the tumour site, all far from the NAC corresponding to the field of radiation. No recurrences were observed in the NAC. In a group of patients characterized by a very close free margin under the areola, no local recurrence was observed. Overall, 36 cases of metastases and 4 deaths were observed. No significant outcome difference was observed between the 800 patients receiving intraoperative radiotherapy (ELIOT) and the 201 patients receiving delayed irradiation.

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“…From a reconstructive perspective, preservation of the NAC improves aesthetic outcomes without increasing the rate of cancer recurrence (7)(8)(9)(10)(11). The principal reconstructive benefit of the technique is preservation of the NAC; however, the NAC is also the most vulnerable anatomical element during the mastectomy and reconstructive procedures.…”

mentioning

confidence: 99%

The effect of incision choice on outcomes of nipple-sparing mastectomy reconstruction

Rawlani¹,

Fiuk²

2011

J Plastic Surgery

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The Psychological Contribution of Nipple Addition in Breast Reconstruction

Cited by 244 publications

References 0 publications

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

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

Nipple sparing mastectomy with nipple areola intraoperative radiotherapy: one thousand and one cases of a five years experience at the European institute of oncology of Milan (EIO)

The effect of incision choice on outcomes of nipple-sparing mastectomy reconstruction

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