Abstract PS2-01-24: Efficacy and safety of intercostal nerve anastomosis in immediate biplane breast reconstruction after nipple-areola-sparing mastectomy: a randomized, controlled, open-label clinical study

Abstract Purpose: to investigate the efficacy and safety of intercostal nerve anastomosis among breast cancer patients who undergo immediate biplane breast reconstruction after nipple-areola-sparing mastectomy. Methods: From 2023 to 2025, 20 to 60 year-old female breast patients (stage I-IIIA), who required and were willing to undergo immediate biplane breast reconstruction after nipple areola-sparing mastectomy, were screened and assigned to take the operation with (treatment group) or without (control group) intercostal nerve anastomosis (selected and dissociated the nerves with appropriate length and thickness among the 2nd to 4th intercostal nerves, then anastomosed to the posterior areola tissue). A radial incision at the surface projection of the tumor location was used. Using Semmes-Weinstein monofilaments to evaluate the patients’ breast local before the operation as well as at 15 days, 3 months, and 6 months postoperatively. Additionally, the patients' quality of life was subjectively assessed using the BREAST-Q scale at 6 months after surgery. Adverse events, operation duration, drainage volume, and the duration of drainage tube carrying time were also monitored and recorded. Results: Compared to the control group, intercostal nerve anastomosis significantly improved the local sensation at 15 days, 3 months, and 6 months postoperatively (P<0.001). Along with the time an improvement was seen in the patients’ local sensation, however, we also noticed a significant decrease in local sensation in both groups (P < 0.001). Whereas the treatment group showed noticeable recovery in sensation at 3 and 6 months postoperatively, while the control group showed a significant reduction. Also, the results of the BREAST-Q scale showed that intercostal nerve anastomosis significantly improved the patients’ quality of life at 6 months postoperatively (P<0.001). Two groups held no significant differences in general characteristics (age, BMI, and subtypes). Intercostal nerve anastomosis did not affect the volume or duration of postoperative drainage tube usage, while it did increase the duration of operation by around 25 min (P < 0.001). Conclusion: This study demonstrates intercostal nerve anastomosis improved the local sensation and quality of life of patients who underwent immediate biplane breast reconstruction after nipple-areola sparing mastectomy. Citation Format: Z. Juan, H. Cai, Y. Liang. Efficacy and safety of intercostal nerve anastomosis in immediate biplane breast reconstruction after nipple-areola-sparing mastectomy: a randomized, controlled, open-label clinical study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-01-24.