Priorities in breast sensation among patients undergoing breast reconstruction.

Abstract

Loss of sensation after breast reconstruction can significantly reduce quality of life. Although novel techniques have aimed to restore sensation, patient priorities and the impact on decision-making remain unclear. We explored patient perspectives on the importance of breast sensation in reconstruction. We conducted a cross-sectional survey of women ≥18 years who underwent breast reconstruction following breast cancer, recruited through online patient communities. Participants provided demographic and cancer-related data, retrospectively ranked sensory modalities, and reported awareness of nerve optimization procedures. Descriptive statistics, t-tests, chi-square tests, and multivariable linear regression were performed. Among 235 participants (mean age, 55 years), tactile sensation was recalled as the most important when considering reconstruction (55%), followed by erogenous sensation (35%). After reconstruction, erogenous sensation was the most missed (49%), followed by tactile sensation (38%). Sensation was important for decision-making in 26% of the participants. Over half (54%) were unaware of nerve optimization procedures but would have considered them if informed, whereas only 16% were aware and had considered them. After adjusting for covariates, awareness and consideration of nerve procedures remained independently associated with higher BREAST-Q Satisfaction with Breasts (p = 0.04). Aware participants also reported significantly higher decision confidence, feeling informed, and Satisfaction with Information compared to unaware participants who would have considered these procedures (all p < 0.05). Patient priorities for breast sensation vary and may shift after reconstruction. Awareness and consideration of nerve optimization procedures are independently associated with improved BREAST-Q satisfaction. Structured preoperative counseling, including discussion of sensory outcomes and nerve optimization options, may improve shared decision-making and postoperative satisfaction.