A recent study from Hubei Cancer Hospital has shown that nipple-sparing mastectomy (NSM) may lead to greater patient satisfaction than skin-sparing mastectomy (SSM) among breast cancer patients undergoing immediate implant-based reconstruction.
Researchers analysed data from 87 patients who underwent unilateral NSM (n=58) or SSM (n=29) followed by reconstruction between January 2022 and January 2024. Patients were matched using propensity scores based on factors such as age, BMI, breast size, and treatment history to ensure clinical comparability. Patient-reported outcomes (PROs) were assessed using the BREAST-Q questionnaire and a decision regret scale.
The results revealed that patients in the NSM group reported significantly higher satisfaction with their breasts (mean score 58.1 vs. 52.9) and better sexual well-being (52.4 vs. 38.9) compared to those in the SSM group. While psychosocial well-being and decision regret showed favourable trends for NSM, these differences did not reach statistical significance.
Multivariate analysis identified a reduction in breast size as a predictor of lower satisfaction and psychosocial well-being, whereas increased breast size was linked to higher levels of decision regret. Complication rates were similar in both groups. Notably, none of the SSM patients underwent nipple reconstruction during follow-up, which may have influenced results.
The findings suggest that, when oncologically safe, NSM should be prioritised to improve post-surgical quality of life. The study also highlights the importance of managing expectations and considering delayed nipple reconstruction for patients undergoing SSM.
Reference
Song Y et al. Comparison of nipple sparing and skin sparing mastectomy with immediate reconstruction based on patient reported outcomes. Sci Rep. 2025; doi.org/10.1038/s41598-025-99834-8.
