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Comparing the Psychological and Cosmetic Outcomes of Nipple-Sparing Mastectomy with Simple Mastectomy
Sara Kryeziu, B.S., Christine Rizk, M.D., Tara L. Huston, M.D..
Stony Brook University School of Medicine, Stony Brook, NY, USA.

Purpose: Reconstruction of the nipple-areolar complex has been shown to be a crucial factor in a woman’s satisfaction and psychological well-being post-mastectomy. Nipple-Sparing Mastectomy (NSM) preserves the natural appearance of the breast and may preserve nipple sensation and erectile function. The purpose of this pilot study was to investigate the influence that NSM has on women's body-image and sexuality and to assess the level of satisfaction with breast reconstruction.
Methods: Questionnaires adapted from the validated Sexual Adjustment and Body Image survey were sent out to 30 simple mastectomy patients and 42 NSM patients who had undergone mastectomy at Stony Brook University Hospital between 2010 and 2014.
Results: Worsened body image was reported in 53.3% of patients who had NSM as compared with 29.4% of patients who had simple mastectomy. Negative effects on sexual satisfaction and sexual relationships were reported in more NSM patients than simple mastectomy patients. Following reconstruction, 40% of NSM patients reported being satisfied with nipple sensation and 66.7% of NSM patients with erectile function of the nipple. Average satisfaction with nipple appearance and position was greater in NSM patients than in simple mastectomy patients.
Conclusion: The preliminary data suggest that although patients undergoing NSM have a higher level of satisfaction with aesthetic outcomes of breast reconstruction, they may also experience more negative effects on body image and sexuality than patients undergoing simple mastectomy. Patients undergoing NSM should be extensively counseled on the possible detrimental effects that they may experience as a result of mastectomy and breast reconstruction.


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