10. Sensory Outcomes of Direct to Implant-based Breast Reconstruction With Targeted Nipple Areola Complex Reinnervation (TNR) Versus Control Patients: A Multicenter Prospective Cohort Study

PURPOSE: To analyze the sensory outcomes of targeted nipple areola complex (NAC) reinnervation (TNR) in nipple-sparring mastectomy with direct to implant-based breast reconstruction versus control patients. METHODS: 32 subjects (59 +TNR breasts) were compared to 24 controls (40 -TNR breasts) using Quantitative Sensory Testing (QST) and the Breast-Q Sensory Module preoperatively and at 1, 3, 6, 9, 12 months postoperatively. Mechanical (monofilaments), vibration (tuning fork), two-point discrimination, pinprick, temperature (automated thermal device) and pressure pain (algometer) detection were measured at the breast and NAC. RESULTS: A median of 2 (1-3) nerves were reconstructed with nerve allograft (2-7cm). QST and Breast-Q Sensory scores were significantly improved in subjects versus controls starting at 3 months postoperatively and reached baseline starting at 12 months (Fig1,2,3). Subjects reported significantly less breast pain starting at 1 month (44% vs 84%, p=0.02) through 12 months postoperatively (13% vs 50%, p=0.06). CONCLUSION: Compared to control, direct to implant-based breast reconstruction with TNR is associated with improved sensation and less breast pain. Long-term outcomes are required to understand the full potential of TNR.