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Preserving Nipple Sensitivity after Breast Cancer Surgery: A Systematic Review and Meta-Analysis.

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Nipple-sparing mastectomy (NSM) preserves nipple sensation, though some decrease is expected. Neurotization shows promise for improved sensation, but standardized testing is needed.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Plastic and Reconstructive Surgery

Background:

  • Breast-conserving surgeries are advancing, increasing focus on patient-reported outcomes like nipple sensation.
  • Understanding nipple-areolar complex (NAC) sensation after breast cancer surgery is crucial for optimizing patient quality of life.

Approach:

  • A systematic literature review following PRISMA guidelines was conducted.
  • Searched databases for studies on nipple sensation, mastectomy, and patient-reported outcomes.
  • Analyzed data from 28 included studies, encompassing objective testing and patient-reported outcome measures (PROMs).

Key Points:

  • Nipple sensation was maintained in 29% of patients without neurotization after NSM.
  • Objective testing showed reduced protective sensation in NSM patients without neurotization compared to controls.
  • NAC neurotization during NSM demonstrated promising results, with one study reporting 100% sensation maintenance.

Conclusions:

  • Nipple-sparing techniques are viable for preserving NAC sensation, though a decrease is generally expected.
  • NAC neurotization during NSM shows potential for enhanced postoperative nipple sensitivity.
  • Lack of standardized sensory testing methodologies across studies necessitates further research.