Abstract

Objective: Persistent postoperative sensory loss poses a significant limitation in breast reconstruction following mastectomy. The absence of sensation profoundly impacts patients' physical well-being and overall quality of life. Surgical techniques have been introduced to neurotize the reconstructed breasts. However, the quality of life after neurotization hasn’t been well evaluated. The purpose of the study was to investigate the improvement of quality of life in accordance to breast neurotization.

Material and Methods: A prospective cohort study of 138 patients with 150 breasts performed in Chang Gung Memorial Hospital between January 2018 and December 2022 was conducted. Two groups of patients who underwent nipple-sparing mastectomy (NSM) and breast reconstruction were compared: those with breast neurotization (n=63), and those without (n=75). The primary outcome was patient-reported outcome assessed by the BREAST-Q™ Reconstruction module questionnaire and additional modified questions regarding the nipple. Objective measurements were conducted by the Semmes–Weinstein monofilaments test.

Results: The neurotization group has a significantly higher score in nipple sensation and Breast-Q domain satisfaction with information provided , medical team, and staff. Linear regression showed a statistically significant relation between the monofilament value and patient-reported nipple sensation, breast sensation, and BREAST-Q score for the domain of psychosocial well-being.

Conclusion: Breast neurotization using the novel technique with autologous nerve graft yields improved sensory outcomes and demonstrated a statistically significant positive impact on the quality of life among breast cancer survivors.

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