Background
Impaired breast sensation can be a devastating consequence of mastectomy and breast reconstruction with significant impacts on quality of life. No previous study has examined correlations between objective breast sensory results and patient-reported outcomes. Herein, we investigate the relationship between cutaneous breast sensation and BREAST-Q scores.
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. A univariate linear regression model assessed the relationship between sensation of various breast regions and BREAST-Q scores. Regions significant on univariate analysis were included in a multivariate linear regression analysis.
Results
185 patients were included: 93 had autologous reconstruction and 92 had alloplastic reconstruction. On multivariate analysis, nipple-areolar complex (NAC) sensitivity was associated with higher Psychosocial Wellbeing (? = 0.15, 95% CI [-0.29, -0.01], p=0.032) and Sexual Wellbeing scores (? = -0.19, 95% CI [-0.35, -0.02], p=0.03). Sensation in all areas of the breast was associated with higher Satisfaction with Breasts scores; these associations were not significant on multivariate analysis. Sensitivity of the lateral breast was independently associated with higher Breast Symptoms scores (? = -0.21, 95% CI [-0.38, -0.05], p=0.02).
Conclusion
Nipple sensitivity is independently associated with Psychosocial and Sexual Wellbeing, underscoring its role as an erogenous zone. General breast sensitivity, rather than a particular region, correlates with breast satisfaction. Heightened sensitivity of the lateral breast is associated with fewer unpleasant symptoms. Reinnervation of the breast pocket after mastectomy begins from the lateral edge of the breast; these findings suggest that unpleasant symptoms (burning, tingling, etc.) precede the recovery of or occur in the absence of “normal” touch sensation.
Figure 1: Univariate and Multivariate Analyses of Breast Sensitivity and BREAST-Q Reconstruction Module Scores
| Breast Areas | Univariate Analysis | Multivariate Analysis | ||
| Beta (95% CI) | p-value | Beta (95% CI) | p-value | |
| Psychosocial Wellbeing | ||||
| Outer | -0.14 (-0.23, -0.05) | < 0.01 | -0.12 (-0.32, 0.07) | 0.21 |
| Inner | -0.12 (-0.21, -0.02) | 0.02 | 0.16 (-0.06, 0.39) | 0.15 |
| Nipple-areolar complex | -0.15 (-0.25, -0.06) | < 0.01 | -0.15 (-0.29, -0.01) | 0.03 |
| Sexual Wellbeing | ||||
| Outer | -0.08 (-0.18, 0.02) | 0.104 | 0.05 (-0.18, 0.29) | 0.67 |
| Inner | -0.09 (-0.19, 0.01) | 0.08 | 0.06 (-0.21, 0.33) | 0.67 |
| Nipple-areolar complex | -0.14 (-0.24, -0.04) | < 0.01 | -0.19 (-0.35, -0.02) | 0.03 |
| Wellbeing of the Chest | ||||
| Outer | -0.05 (-0.16, 0.05) | 0.33 | ||
| Inner | -0.02 (-0.12, 0.09) | 0.72 | ||
| Nipple-areolar complex | -0.04 (-0.15, 0.07) | 0.47 | ||
| Satisfaction with Breasts | ||||
| Outer | -0.24 (-0.33, -0.13) | < 0.01 | -0.09 (-0.29, 0.10) | 0.35 |
| Inner | -0.22 (-0.32, -0.12) | < 0.01 | -0.01 (-0.23, 0.21) | 0.95 |
| Nipple-areolar complex | -0.22 (-0.32, -0.12) | < 0.01 | -0.07 (-0.21, 0.07) | 0.33 |
