Breast Sensation and Quality of Life: Correlating Cutaneous Sensitivity of the Reconstructed Breast and BREAST-Q Scores.

Overview

abstract

BACKGROUND: Impaired breast sensation can be a devastating consequence of mastectomy and breast reconstruction with significant impacts on quality of life. Few studies have examined the relationship between objective breast sensory results and patient-reported outcomes. Herein, we the relationship between cutaneous sensation of different anatomic regions of the breast and BREAST-Q scores in patients with autologous and alloplastic breast reconstruction. METHODS: Patients with postmastectomy breast reconstruction completed the BREAST-Q and underwent breast sensory testing with a pressure-specified sensory device. BREAST-Q responses and sensation measurements were paired; any instance without both outcomes was dropped from the analysis. Univariate linear regression models assessed the relationship between sensation of various breast regions and BREAST-Q scores. Breast regions significant on univariate analysis were included in a multivariate linear regression analysis. RESULTS: One hundred ninety-four patients were included: 112 had autologous reconstruction and 82 had alloplastic reconstruction. In autologous patients, nipple-areolar complex (NAC) sensitivity was independently associated with higher Psychosocial Wellbeing [β = -0.20 (-0.36, -0.04); adjusted R2 = 0.09; P = 0.01] and Sexual Wellbeing scores [β = -0.26 (-0.46, -0.06); adjusted R2 = 0.05; P = 0.04]. Sensation in all areas of the breast was associated with higher Satisfaction with Breasts scores; these associations were not significant on multivariate analysis. In alloplastic patients, only NAC sensitivity was associated with Sexual Wellbeing scores [β = -0.10 (-0.16, -0.04); R2 = 0.03; P = 0.002]. No other significant associations were observed between Breast Sensitivity and Psychosocial Wellbeing, Physical Wellbeing of the Chest, and Satisfaction with Breasts scores in the alloplastic cohort. CONCLUSIONS: NAC sensitivity significantly correlates with breast reconstruction patients' psychosocial and Sexual Wellbeing, particularly in patients undergoing neurotized autologous reconstruction, while overall breast sensitivity is associated with breast satisfaction. Weaker correlations in the alloplastic cohort suggest that breast sensitivity may play a more substantial role in patient-reported outcomes for patients receiving autologous reconstruction. These findings underscore the importance of restoring NAC sensation during breast reconstruction. Future research incorporating sensation-specific patient-reported outcome measures and examining additional sensory domains will further enhance our understanding of sensory recovery's impact on postreconstruction quality of life.