by Kostidou, Eleni;
Schmelz, Martin; Hasemaki, Natasha; Kokotis, Panagiotis
Background: The
breast and the factors that affect the sensitivity of the nipple-areola complex
have been a significant subject of study in recent years. The main purpose of
this study was to provide an objective assessment of the effect of volumetric
differences on nipple-areola complex sensitivity. Methods: Data were collected examining the right breast of 34
female volunteers. The mechanosensitive Aβ-fiber and mechanoinsensitive C-fiber
function of the nipple-areola complex was assessed after mechanical and
chemical stimulation, respectively. Flare responses were elicited chemically by
the application of histamine by means of iontophoresis and recorded by laser
Doppler imaging. The correlation of the maximum flare area responses with the
breast volume and nipple-areola complex and the response from the von Frey
fiber test was estimated using linear regression analysis.
Results:
Nipple-areola complex area increased with breast volume and, similarly, the
area of histamine-induced axon reflex flare response follows the larger
nipple-areola complex. However, a larger nipple-areola complex correlated with
higher local mechanical thresholds. Higher mechanical thresholds were linked to
smaller axon reflex area, suggesting combined small- and thick-fiber neuropathy.
Conclusions:
Objective small-fiber assessment using laser Doppler imaging and subjective
mechanical threshold tests were used successfully to quantify function of Aβ
and C fibers in the nipple-areola complex. Increased breast volume was linked
to larger nipples, but also to impairment of Aβ and C fibers. Sensory testing
can be incorporated into preoperative and postoperative management of patients
undergoing breast operations to assess changes of neuronal function of the
nipple-areola complex after surgery.
