ArticleAnnals of surgical oncology2026
Predictors of Satisfaction with Breasts and Psychosocial Well-Being After Nipple-Sparing Mastectomy.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNipple-sparing mastectomy (NSM) confers similarly excellent patient-reported outcomes (PROs) as skin-sparing mastectomy; however, the relative weight of individual patient- and treatment-related factors on satisfaction with breasts and psychosocial well-being following NSM is unclear. We assessed predictors of PROs following NSM.
methodsPatients undergoing NSM between April 2018 and July 2021 at a single institution were included in a prospective examination. Routinely collected preoperative and postoperative BREAST-Q responses were recorded. Univariable and multivariable linear regression identified predictors of satisfaction with breasts and psychosocial well-being.
results333 patients underwent NSM; median age was 43 years (interquartile range [IQR] 37-49 years). Of patients, 86% received two-stage reconstruction with tissue expander (TE) followed by an implant; 12% received postmastectomy radiation (PMRT). At 1 year, receipt of PMRT predicted lower satisfaction (b = - 32 [95% confidence interval (CI) - 42- - 22], p < 0.001) and psychosocial well-being (b = - 43 [- 56- - 30], p < 0.001), as did TEs, compared with autologous tissue reconstruction for both satisfaction (b = -15 [- 27- - 3.4], p = 0.012) and well-being (b = -31 [- 52- - 11], p =0.004). At 2 years, PMRT remained a significant negative predictor of satisfaction (b = -14 [95% CI -24- - 3.5], p = 0.009) and well-being (b = -16 [95% CI -31- - 0.97], p = 0.04) but reconstruction type was not (p = ns). Full-thickness skin-flap necrosis predicted poorer satisfaction at 1 year (b = -19 [95% CI - 34- - 4.6], p = 0.01) but not at 2 years (p = ns). Higher preoperative psychosocial well-being was positively associated with postoperative scores at 1 and 2 years.
conclusionsReceipt of PMRT is persistently and negatively associated with PROs at up to 2 years after NSM. Longer follow-up is needed to assess the impact of reconstruction type on these outcomes.
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