Breast sensitivity after mastectomy and autologous reconstruction

BACKGROUND: Breast Carcinoma is the most common malign tumor disease in women. 20-30% of these tumors have to be treated by removing all of the breast tissue. After that kind of therapeutic procedure, most of the women are severely traumatized and ask for reconstruction. The goldstandard of breast reconstruction is the free perforator flap from the lower abdomen (DIEAP-flap), which can provide body-own tissue and natural shape for the reconstructed breast. Many studies evaluate the shape of the reconstructed breast but neglect the skin sensitivity. Claim of this study was to compare this important part of reconstruction on two different techniques of mastectomy. OBJECTIVE: In this retrospective study we evaluated which technique of mastectomy and breast reconstruction with DIEAP-Flap offers the highest outcome for sensibility of the reconstructed breast. Skin sparing mastectomy was compared with conventional mastectomy and the results of skin sensitivity were measured. METHODS: Ten patients underwent breast reconstruction with free abdominal perforator flap between 2011 and 2015 after conventional mastectomy (CM) and were compared with ten patients, who had a skin sparing mastectomy (SSM) with immediate reconstruction by DIEAP-flap during the same time interval. These two groups were matched by age, height, weight and the time between reconstruction and examination. The sensitivity of the skinwas measured by Semmes-Weinstein-Filaments in the strength beginning from 0,07 g till 300 g for deep sensation. The logarithmic profile of these measurements had been transferred into a continuous data system beginning from 1 point, which stands for no sensation, till 7 points for pressure threshold of 0,07 g. RESULTS: Patients who underwent DIEAP-reconstruction after skin sparing mastectomy showed a higher sensation at all regions of the new breast in comparison to reconstruction after conventional mastectomy, beginning from the nipple to the areola and the breast skin. The results in the CM-group were 1.0 points at the mamilla, 1.33 pts. at the areola and 1.78 pts. at the breast skin. In the SSM-group, the findings were 3 pts. at the mamilla, 3.25 pts. at the areola and 5.25 pts. at the breast skin. CONCLUSION: The skin sparing mastectomy combined with immediate reconstruction by DIEAP-flap provides an excellent therapeutic option for patients, who are suitable for this technique, which takes into account not only the form but also the sensitivity of the breast.