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Nipple-Areola Complex Reconstruction Improves Psychosocial and Sexual Well-Being in Women Treated for Breast Cancer
Michael R. Bykowski, M.D.1, Patrick I. Emelife, M.D.2, Nancy N. Emelife, M.D.3, Wendy Chen, M.D.1, Nicholas J. Panetta, M.D.4, Carolyn de la Cruz, M.D.1.
1University of Pittsburgh Medical Center, Pittsburgh, PA, USA, 2Louisiana State University Health Sciences Center, New Orleans, LA, USA, 3Tulane University, New Orleans, LA, USA, 4University of South Florida, Tampa, FL, USA.
Background: Women choose to undergo nipple-areola complex (NAC) reconstruction as part of breast reconstruction following breast cancer. However, the impact of this procedure on psychosocial and sexual well-being is not well defined. The goal of this study is to evaluate how NAC reconstruction impacts patient satisfaction with regards to psychosocial and sexual well-being.
Methods: A retrospective chart review was performed on all patients who underwent NAC reconstruction at Magee-Womens Hospital from January 1, 2004 to July 31, 2011. A letter and questionnaire based on the BREAST-Q were mailed to patients requesting participation in the study. Patient satisfaction and health-related quality of life (HRQOL) were measured before and after NAC reconstruction.
Results: In total, 107 of 328 patients (32.6%) submitted the survey. The BREAST-Q scale score for satisfaction with outcome following NAC reconstruction was 85.1 ± 15.8 with higher satisfaction scores for patients with follow-up of <1.5 years compared to those with follow-up of >2.5 years (82.5 ± 21.7 vs. 69.5 ± 19.5; p< 0.01). No significant differences were found with satisfaction of the breast mound before and after NAC reconstruction. Women scored significantly higher on the psychosocial and sexual well-being scales after NAC reconstruction (p<0.002 and <0.00004).
Conclusions: This study indicates that patients are highly satisfied after undergoing NAC reconstruction. Satisfaction with the procedure, however, may decrease over time. NAC reconstruction contributes significantly to patient psychosocial and sexual well-being and that effect did not change over time. NAC reconstruction improves patient outcomes in those who elect to undergo the procedure. 
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