Patient and Surgeon’s Concerns with Post-Mastectomy Nipple Reconstruction: An Alternative to Traditional Nipple Reconstruction
DOI:
https://doi.org/10.17140/CTPOJ-6-124Keywords:
Breast cancer, Reconstructive surgery, Quality-of-life post-mastectomy, mastectomy, Reconstructive breast surgery, Women’s healthAbstract
Aims
The aim of this paper is to determine what women who undergo reconstructive surgery after mastectomy (due to breast cancer)
are seeking. It also answers the question, how plastic surgeons are attempting to fill this need.
Methods
A survey was undertaken of 84 plastic surgeons and 70 of their patients who underwent recent mastectomy and reconstruction
surgery. All the material was deidentified before analysis.
Results
The majority of the women wanted their breasts and nipples to be natural and have the same appearance (or sometimes to be
more attractive) or similar appearance.
Conclusion
Women undergoing this type of surgery frequently develop a decreased quality-of-life (QoL) which also affects their feeling
of femininity, sexuality, and psychological well-being. The post-surgery time period and the additional necessary treatments are
extremely stressful events. The importance of their breast post-operative aesthetics correlated with their self-esteem and body
image. It is important for plastic surgeons to take these factors into consideration, when planning their reconstructive surgery.
References
Soon PS, Ruban S, Mo HTJ, et al. Understanding patient choices regarding breast reconstruction after mastectomy for breast can-cer. Support Care Cancer. 2019; 27: 2135-2142. doi: 10.1007/s00520- 018-4470-0
Koçan S, Gürsoy A. Body image of women with breast can-cer after mastectomy: A qualitative research. J Breast Health. 2016; 12(4): 145-150. doi: 10.5152/tjbh.2016.2913
Scribbr. Ibid, 1. What Does Ibid. Mean? Web site. https://www. 6 Klein GL, et al scribbr.com/citing-sources/ibid/. Accessed October 29, 2022.
Matthews H, Turner A, Williamson I, Clyne W. ‘It’s a silver lining’: A template analysis of satisfaction and quality of life fol-lowing post-mastectomy breast reconstruction. Br J Health Psychol. 2018: 23(2): 455-475. doi: 10.1111/bjhp.12299
Spector DJ, Mayer DK, Knaf K, Pusic A. Women’s recovery experiences after breast cancer reconstruction surgery. J Psychosoc Oncol. 2011; 29: 664-676. doi: 10.1080/07347332.2011.615384
Kristoffersen CM, Seland H, Hansson E. A systematic review of risksandbenefitswithnipple-areola-reconstruction.JPlastSurgHand Surg. 2017; 51: 287-295. doi: 10.1080/2000656X.2016.1251935
Holland F, Archer S, Montague J. Younger women’s experienc-es of deciding against delayed breast reconstruction post-mas-tectomy following breast cancer: An interpretative phenome-nological analysis. J Health Psychol. 2016; 21(8): 1688-1699. doi: 10.1177/1359105314562085
Schmidt J, Wetzel CM, Lange KW, Heine N, Ortmann O. Pa-tients’ experience of breast reconstruction after mastectomy and its influence on postoperative satisfaction. Arch Gynecol Obstet. 2017; 296: 827-834. doi: 10.1007/s00404-017-4495-5
Male DA, Fergus KD, Cullen K. Sexual identity after breast cancer surgery, sexuality, body image, and relationships. Curr Opin Support Palliat Care. 2016; 10(1): 66-74. doi: 10.1097/ SPC.0000000000000184
Spenser KW. Significance of the breast to the individual and society. Plast Surg Nurs. 1996; 16: 131-132.
Cash TF. Cognitive-behavioral perspectives on body image. In: Encyclopedia of Body Image and Human Appearance. MA, USA: Elsevier Academic Press; 2012: 334-342.
Cash TF. The assessment of body image: An extensive revision of the Appearance Schemas Inventory. Int J Eating Disorder. 2004; 35: 305-316. doi: 10.1002/eat.10264
Zucca MG, Manconi A. The evolution of mastectomies in the oncoplastic breast surgery era. Gland Surg. 2013; 2: 102-106. doi: 10.3978/j.issn.2227-684X.2013.05.03
Duggal CS, Metcalfe D, Sackeyfio R, Carlson GW, Losken A. Patient motivations for choosing postmastectomy breast re-construction. Ann Plast Surg. 2013; 70(5): 574-580. doi: 10.1097/ SAP.0b013e3182851052
Shestak KC, Gabriel A, Landecker A, Peters S, Shestak A, Kim J. Assessment of long-term nipple projection: A comparison of three techniques. Plast Reconstr Surg. 2002; 110: 780-786. doi: 10.1097/00006534-200209010-00010 Brief Research Report | Volume 6 | Number 1 |
Collins B, Williams JZ, Karu H, Hodde JP, Martin VA, Gurtner GC. Nipple reconstruction with the biodesign nipple reconstruc-tion cylinder: A prospective clinical study. Plast Reconstr Surg Glob Open. 2016; 4: e832. doi: 10.1097/GOX.0000000000000846
Spenser KW. Significance of the breast to the individual and society. Plast Surg Nurs. 1996; 16: 131-132.
Wagner JL. Prospective evaluation of nipple areolar complex sparing mastectomy for risk reduction and early-stage breast can-cer. Ann Surg Oncol. 2012; 19(4):1137-44. doi: 10.1245/s10434-011- 2099-z
Klein GL, Johnson PC. Potential psychological benefit for a regenerative graft for nipple reconstruction. Journal of Aesthetic & Reconstructive Surgery. 2021; 7(2): 1-4.
Metcalfe KA. Long term psychosocial function in women with bilateral prophylactic mastectomy: Does presence of the nipple areolar complex make a difference? Ann Sur Oncol. 2015; 22: 3324- 3330. doi: 10.1245/s10434-015-4761-3
Qureshi AA, Odom EB, Parikh RP, Myckatyn TM, Tenenbaum MM. Patient-reported outcomes of aesthetics and satisfaction in immediate breast reconstruction after nipple-sparing mastectomy with implants and fat grafting. Aesthet Surg J. 2017; 37: 999-1008. doi: 10.1093/asj/sjx048
Pashos NC, Graham DM, Burkett BJ, et al. Acellular biolog-ic nipple–areolar complex graft: In vivo murine and non-human primate host response evaluation. Tissue Eng Part A. 2020; 26: 872- Submit your article to this journal | https://openventio.org/submit-manuscript/ Brief Research Report | Volume 6 | Number 1 | Klein GL, et al 885. doi: 10.1089/ten.TEA.2019.0222
Johnson PC, Klein GL. Orthotopic grafting of decellularized human nipple: Setting the stage and putative mechanism of heal-ing. Breast. 2020; 54: 96-98. doi: 10.1016/j.breast.2020.09.007
Parvez E, Martel K, Morency D, et al. Surgical and oncologic outcomes of nipple-sparing mastectomy for a cohort of breast cancer patients, including cases with high-risk features. Clin Breast Cancer. 2020; 20: 353-358. doi: 10.1016/j.clbc.2020.03.001
Scribbr. Ibid, 12. Web site. https://www.scirp.org/(S(lz5m-qp453ed%20snp55rrgjct55))/reference/referencespapers.aspx?referen-ceid=1590511. Accessed October 29, 2022.
Caronna VC, Rosenberg AF, Graham DM, et al. Viability of acellular biologic graft for nipple-areolar complex reconstruction in a non-human primate model. Sci Rep. 2021; 11: 15085. doi: 10.1038/s41598-021-94155-y
Gunnarsson GL, Heidemann LN, Bille C, Sørensen JA, Thom-sen JB. Nipple sparing mastectomy and the evolving direct to im-plant breast reconstruction. Gland Surg. 2018; 7(3): 267-272. doi: 10.21037/gs.2017.08.06
Bykowski MR, Emelife PI, Emelife NN, Chen W, Panetta NJ, de la Cruz C. Nipple-areola complex reconstruction improves psy-chosocial and sexual well-being in women treated for breast cancer. J Plast Reconstr Aesthet Surg. 2017; 70(2): 209-214. doi: 10.1016/j. bjps.2016.10.009
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Clinical Trials and Practice – Open Journal (CTP) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
