Jackson RS, et al. - Nipple-sparing mastectomy (NSM) seemed more technically challenging than skin-sparing mastectomy (SSM) but offers quality-of-life and cosmetic advantages. This study sought to document surgeon physical symptoms related to NSM workload. Researchers realized that surgeons experienced greater physical symptoms, mental strain, and fatigue with NSM than SSM. Over the course of a breast surgeon’s career, these mild but repetitive pain could lead to repetitive stress injury.

Methods

• Researchers performed this prospective study using questionnaires to compare surgeon-reported physical symptoms before, during, and after NSM versus SSM.
• They, in addition, asked surgeons general questions regarding each mastectomy.
• Two surgeons performed bilateral cases simultaneously and completed independent questionnaires.

Results

• After 82 SSMs and 44 NSMs, questionnaires were completed.
• In this study, on a 0–10 scale, surgeons reported NSM was more physically demanding than SSM (7.0 vs. 4.5, p < 0.001).
• After NSM, mean visualization seemed more difficult (5.7 vs. 3.2, p < 0.001) and mean fatigue score was greater (5.6 vs. 3.1, p < 0.001) than SSM.
• For NSM, the mean increase in neck pain (on a 0–4 scale) was more in comparison to SSM, both from before-to-during surgery (0.8 vs. 0.2, p = 0.003) and before-to-after surgery (0.9 vs. 0.2, p = 0.002).
• In lower back pain, the mean increase was more for NSM than SSM, both from before-to-during surgery (0.7 vs. 0.2, p = 0.008) and before-to-after surgery (0.9 vs. 0.2, p = 0.003).
• As per surgeons' reports, NSM was more mentally demanding (p < 0.001), complex (p = 0.01), and difficult (p < 0.001) than SSM.