Randomized Feasibility Study to Determine the Feasibility of Neurotization of the Nipple Areolar Complex at the Time of Nipple Sparing Mastectomy and Prosthetic Based Reconstruction
This phase II trial tests the willingness of patients undergoing nipple sparing mastectomy (NSM) to enroll in a randomized study of NSM with or without neurotization of the nipple areolar complex (NAC). This trial also compares patient reported outcomes, including quality of life and breast and NAC sexual functionality, for patients undergoing NSM with or without neurotization of the NAC. NSM is a standard practice option for patients undergoing preventative mastectomy, but many report dissatisfaction with decreased nipple sensation. Neurotization is a surgical technique using a nerve graft in an attempt to restore NAC sensation. Neurotization during NSM and reconstruction may restore NAC sensation and improve quality of life in breast cancer patients.
• Female patients age \>= 18
• Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2
• Planned nipple sparing mastectomy (NSM)
• Ideal NSM candidates would meet the following criteria:
‣ Cup size A-C
⁃ BMI \<34
⁃ Ptosis grade \< 2
⁃ Clinical stage 0 - T2N0
⁃ Final planned implant volume \< 400cc
⁃ Inframammary or lateral mammary incision
⁃ Tumor \> 0.5cm from the nipple areolar complex (NAC)
⁃ No prior breast reduction, mastopexy, or periareolar incisions on side of planned NSM
⁃ No prior breast radiation on side of planned NSM
⁃ Tumor \<0.5cm from NAC (including suspicious calcifications or MRI enhancement)
⁃ No planned post mastectomy radiation (PMRT)
⁃ No nicotine use within 4 weeks of surgical date