Quality-of-life outcomes improve with nipple-sparing mastectomy and breast reconstruction

Christopher R. Bailey, Onyebuchi Ogbuagu, Pablo A. Baltodano, Usamah F. Simjee, Michele A. Manahan, Damon S. Cooney, Lisa K. Jacobs, Theodore N. Tsangaris, Carisa M. Cooney, Gedge D. Rosson

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Background: Loss of the nipple-areola complex can be psychologically and sexually devastating. Nipple-sparing mastectomy provides robust cosmetic results, but few studies have investigated the quality-of-life outcomes associated with it. Methods: The authors performed an institutional review board-approved retrospective study of 32 patients who underwent nipple-sparing mastectomy with implant-based or autologous reconstruction and 32 control patients who underwent non-nipple-sparing mastectomy with reconstruction matched by reconstruction type and operative period. They then compared premastectomy and postreconstruction responses to the BREAST-Q, a validated and breast reconstruction-specific quality-of-life questionnaire, within and between their study and control populations. Results: The nipple-sparing and non-nipple-sparing mastectomy groups were statistically similar in terms of mean age [49.9 ± 8.5 years (range, 36 to 69 years) and 47.7 ± 10.3 years (range, 26 to 68 years) (p = 0.29), respectively] and mean body mass index [24.3 ± 3.5 kg/m2 (range, 17.9 to 33.7 kg/m2) and 25.5 ± 5.4 kg/m2 (range, 19.2 to 39.2 kg/m2) (p = 0.29), respectively]. There were no significant between-group differences in occurrence of postreconstruction complications. The authors found significantly higher mean postreconstruction scores in the nipple-sparing mastectomy group within the Satisfaction with Breasts (p = 0.039) and the Satisfaction with Outcome (p = 0.017) domains. Finally, they noted higher median postreconstruction scores in the nipple-sparing mastectomy group within the Psychosocial Well-being (p = 0.043) and Satisfaction with Breasts (p = 0.004) domains. Conclusions: Psychological concerns regarding malignancy may negatively impact premastectomy patient quality of life. Reconstructive surgery improves patients' postmastectomy quality of life. Nipple-sparing mastectomy appears to provide significantly better improvement in postreconstruction quality of life, specifically in the Satisfaction with Breasts and Satisfaction with Outcome domains of the BREAST-Q, compared with non-nipple-sparing mastectomies.

Original languageEnglish (US)
Pages (from-to)219-226
Number of pages8
JournalPlastic and reconstructive surgery
Issue number2
StatePublished - Aug 1 2017

ASJC Scopus subject areas

  • Surgery


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