Related Experiment Video
Updated: May 11, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Priorities in breast sensation among patients undergoing breast reconstruction
Lily Zhu1, Ganiat A Giwa1, Kimberly H Khoo1
1Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Purpose:
Loss of sensation after breast reconstruction can significantly reduce quality of life. Although novel techniques have aimed to restore sensation, patient priorities and the impact on decision-making remain unclear. We explored patient perspectives on the importance of breast sensation in reconstruction.
Methods:
We conducted a cross-sectional survey of women ≥18 years who underwent breast reconstruction following breast cancer, recruited through online patient communities. Participants provided demographic and cancer-related data, retrospectively ranked sensory modalities, and reported awareness of nerve optimization procedures. Descriptive statistics, t-tests, chi-square tests, and multivariable linear regression were performed.
Results:
Among 235 participants (mean age, 55 years), tactile sensation was recalled as the most important when considering reconstruction (55%), followed by erogenous sensation (35%). After reconstruction, erogenous sensation was the most missed (49%), followed by tactile sensation (38%). Sensation was important for decision-making in 26% of the participants. Over half (54%) were unaware of nerve optimization procedures but would have considered them if informed, whereas only 16% were aware and had considered them. After adjusting for covariates, awareness and consideration of nerve procedures remained independently associated with higher BREAST-Q Satisfaction with Breasts (p = 0.04). Aware participants also reported significantly higher decision confidence, feeling informed, and Satisfaction with Information compared to unaware participants who would have considered these procedures (all p < 0.05).
Conclusions:
Patient priorities for breast sensation vary and may shift after reconstruction. Awareness and consideration of nerve optimization procedures are independently associated with improved BREAST-Q satisfaction. Structured preoperative counseling, including discussion of sensory outcomes and nerve optimization options, may improve shared decision-making and postoperative satisfaction.
