Comparison of nipple sparing and skin sparing mastectomy with immediate reconstruction based on patient reported outcomes

作者：Yuhang Song, Lingzi Wang, Wenqin Huang, Senyang Guo, Xinhong Wu, Hongmei Zheng · 发表于：Scientific Reports · 年份：2025 · DOI：10.1038/s41598-025-99834-8 · 被引用次数：9 · 研究领域：Breast Implant and Reconstruction、Body Image and Dysmorphia Studies、Reconstructive Surgery and Microvascular Techniques

Nipple-sparing mastectomy (NSM) and skin-sparing mastectomy (SSM) are widely accepted surgical options for breast cancer patients undergoing immediate reconstruction. However, the impact of preserving the nipple-areolar complex on patient-reported outcomes (PROs) remains uncertain, particularly in clinically matched settings. This retrospective study included patients who underwent unilateral NSM or SSM followed by immediate implant-based breast reconstruction at Hubei Cancer Hospital between January 2022 and January 2024. Patients were propensity score matched (2:1) based on age, body mass index, preoperative breast size, neoadjuvant chemotherapy, implant plane, and postmastectomy radiation therapy. PROs were assessed using the BREAST-Q (version 2.0) and the decision regret scale. Univariate and multivariate linear regression analyses were conducted to identify predictors of satisfaction and regret. A total of 87 patients were included after matching (NSM: n = 58; SSM: n = 29). NSM patients reported significantly higher satisfaction with breasts (mean 58.1 vs. 52.9, P = 0.038) and sexual well-being (mean 52.4 vs. 38.9, P = 0.035). Although psychosocial well-being and decision regret showed favorable trends in the NSM group, differences were not statistically significant. Multivariate analysis revealed that reduction in breast size was significantly associated with decreased satisfaction and psychosocial well-being, while increased breast size was linked to greater decision r...