Is the sensitivity of skin-sparing mastectomy or nipple-sparing mastectomy superior to conventional mastectomy with innervated flap?

Abstract

The purpose of this study was to investigate sensory recovery in 33 patients who underwent conventional mastectomy, skin-sparing mastectomy, or nipple-sparing mastectomy with immediate breast reconstruction using abdominal flaps. Reconstructions included a pedicled transverse (28 cases) or vertical (five cases) rectus abdominis musculocutaneous flap. Sensory reconstruction was performed in 15 cases by neurorrhaphy using intercostal nerve. Patients were classified into six groups according to type of mastectomy and use of neurorrhaphy. Sensory recovery was estimated by touch, pain, and hot and cold sensation at the nipple, areola, and 4 points at a distance of 2 cm from the areolar circumference. For touch sensation, conventional mastectomy with innervated flap provided greater sensitivity than the other groups (P < 0.05). For pain sensation, conventional mastectomy with innervated flap provided greater sensitivity than the other groups (P< 0.05). In terms of short-term postoperative sensitivity, skin- and nipple-sparing mastectomies with abdominal flap appear inferior to conventional mastectomy with innervated abdominal flap. Copyright © 2011 Wiley-Liss, Inc.