Nipple-sparing mastectomy (NSM) is considered an oncologically safe option for select patients. As many patients are candidates for nipple-sparing or skin-sparing mastectomy (SSM), reliable patient-reported outcome data are crucial for decision-making. The objective of this study was to determine whether patient satisfaction and/or health-related quality of life (HRQOL) were improved by preservation of the nipple with NSM compared to SSM and nipple reconstruction. Subjects were identified from a prospectively maintained database of patients who completed the BREAST-Q following mastectomy and breast reconstruction between March and October 2011 at Memorial Sloan Kettering Cancer Center. Fifty-two patients underwent NSM followed by immediate expander-implant reconstruction. A comparison group consisted of 202 patients who underwent SSM followed by immediate expander-implant reconstruction and later nipple reconstruction. HRQOL and satisfaction domains as measured by BREAST-Q scores were compared in multivariate linear regression analyzes that controlled for potential confounding factors. NSM patients reported significantly higher scores in the psychosocial (p = 0.01) and sexual well-being (p = 0.02) domains compared to SSM patients. There was no significant difference in the BREAST-Q physical well-being, satisfaction with breast, or satisfaction with outcome domains between the NSM and SSM groups. NSM is associated with higher psychosocial and sexual well-being compared to SSM and nipple reconstruction. Preoperative discussion of such HRQOL outcomes with patients may facilitate informed decision-making and realistic postoperative expectations.
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http://dx.doi.org/10.1111/tbj.12542 | DOI Listing |
CJEM
January 2025
Dalla Lana School of Public Health, University of Toronto, Scarborough Health Network Research Institute, Toronto, ON, Canada.
Purpose: Intersex people make up 1.7-4% of the population of North America. A recent scoping review of emergency department (ED) relevant literature for the care of sexual and gender minorities found almost no representation of this population.
View Article and Find Full Text PDFJ Acquir Immune Defic Syndr
December 2024
Department of Psychiatry and Sociomedical Sciences, Columbia University, New York, NY.
Background: We assessed access to pre-exposure prophylaxis (PrEP) and interest in integration of PrEP with gender-affirmative care in a global sample of transmasculine persons.
Methods: Transmasculine persons (N = 590) aged 18 years and above from 57 countries completed a brief online survey from April to July 2022 about sexual behavior, knowledge, and interest in PrEP, current access to PrEP and gender-affirmative care, and preferred context for accessing PrEP. Descriptive analyses were stratified by country income group.
J Acquir Immune Defic Syndr
December 2024
Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY.
Background: In sub-Saharan Africa, pediatric and adult treatment programs have not met the needs of youth living with HIV (15-24 years), whose enrollment in antiretroviral treatment (ART) programs is much lower than that of adults. To inform targeted interventions, we analyzed factors associated with ART use among youth in Uganda.
Methods: Data were from 42 communities between 2011 and 2020 (5 survey rounds) from the Rakai Community Cohort Study, an open, population-based cohort.
Nursing
December 2024
At California State University, Sacramento in Sacramento, Calif., Christi Camarena is an assistant professor, Carlisle Cameron is a nursing student, and Bridget Parsh is a professor. Dr. Parsh is also a member of the Editorial Board of Nursing2024.
Br J Nurs
January 2025
Professor of Nursing and Head of School, Buckinghamshire New University.
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