Sensitivity after bilateral prophylactic mastectomy and immediate reconstruction.

Area of Science:

• Surgical Oncology
• Plastic Surgery
• Neuroscience

Background:

• Prophylactic mastectomy is a risk-reducing surgery for individuals with high genetic predisposition to breast cancer.
• Immediate breast reconstruction with implants is a common choice following mastectomy.
• Understanding the impact on sensory function is crucial for patient counseling and quality of life.

Purpose of the Study:

• To evaluate cutaneous somatosensory function after bilateral prophylactic mastectomy and immediate implant reconstruction.
• To assess patients' subjective experience, including sensitivity and sexual feelings, post-surgery.
• To compare sensory outcomes with a control group of women without prior breast surgery.

Main Methods:

• Retrospective study including 24 patients undergoing bilateral prophylactic mastectomy and immediate implant reconstruction.
• Quantitative somatosensory examination (touch, warmth, cold, heat pain perception thresholds) performed at least two years post-surgery.
• Patient questionnaires assessing subjective sensitivity and sexual feelings; comparison with 16 controls.

Main Results:

• Most patients reported decreased breast sensitivity, confirmed by quantitative somatosensory testing.
• The ability to experience sexual feelings in the breast was generally lost post-operation.
• 14 out of 24 patients reported spontaneous or stimulus-evoked breast discomfort.

Conclusions:

• Bilateral prophylactic mastectomy with immediate implant reconstruction significantly impairs cutaneous somatosensory function.
• The procedure commonly leads to loss of sexual sensation and can cause persistent breast discomfort.
• These findings highlight the importance of discussing sensory deficits and potential discomfort with patients.