Abstract PO5-23-03: Impact of prosthetic nipple reconstruction after mastectomy on quality of life
Authors: Buonomo Oreste Claudio , Caspi Jonathan , Materazzo Marco , Pellicciaro Marco , Vanni Gianluca 
Published: May 2024

Introduction

Post-mastectomy breast reconstruction (PMBR) is considered complete after nipple-areola complex (NAC) restoration, which is pivotal in restoring body image, and enhancing the psychosocial and sexual well-being of women treated for Breast Cancer (BC). Various methods, including nipple sharing, skin grafts, and local flaps with or without augmenting materials, have been proposed to achieve optimal aesthetic results. Despite these strategies, NAC flattening remains a common complication, leading to diminished aesthetic outcomes. To address this issue, a nipple reconstruction implant (NRI) (FixNip NRI™) has been developed. This study aims to assess patient quality of life (QoL) following prosthetic nipple reconstruction.

Materials and Methods

A multinational (Tor Vergata University and Israel) multicentric retrospective study with a prospectively maintained database was designed. The primary outcome was the comparative analysis of patients who underwent NRI with patients who received PMBR without NAC reconstruction. The Nipple Reconstruction (NR) group included patients with grade I and II capsular contracture, no active BC, and NAC reconstruction with NRI between 2019 and 2022. All patients were assessed post-surgery at 1-week, 3-months, 6-months, and 1-year intervals to measure NAC projection. In addition, satisfaction with Breasts, Physical Well-being, Psychosocial Well-being, and Sexual Well-being were evaluated using the Breast-Q score at each time interval. The NR group was compared using a propensity match score (PMS) from a prospectively maintained database of patients undergoing mastectomy without NAC reconstruction in the same time frame in Tor Vergata University. Breast Q score Within group and Between group analysis were performed with Wilcoxon-Mann-Whitney test.

Results

Eleven patients were enrolled in the NR group. A total of 53 female patients were considered for the NN group. Following a PMS analysis, 11 patients were included in this study group to achieve a 1:1 ratio with the NR Group, accounting for confounding variables (Table I). In the NR group, the mean procedure time was 21 minutes. Mean NAC projections were 3.4 mm, 3.5 mm, 3.6 mm, and 3.6 mm at 1 week, 3 months, 6 months, and 1 year, respectively. No statistically significant difference in nipple projection over time was observed. Table II presents the Breast Q score among groups at 1 week and 1 year. in the between group analysis NR group showed a statistically significant difference in all the descriptors analyzed. Within-group analysis revealed a higher value of sexual well-being in the NR group at 1 year.

Conclusion

Despite the small sample size, the NRI offers a promising solution for NAC reconstruction, maintaining nipple projection, and enhancing patients’ quality of life.

Table I: Confounding Variable

Table II: Breast Q score analysis

Citation Format: Oreste Claudio Buonomo, Jonathan Caspi, Marco Materazzo, Marco Pellicciaro, Gianluca Vanni. Impact of prosthetic nipple reconstruction after mastectomy on quality of life [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-23-03.