Many cancer survivors who have undergone masectomies and breast reconstruction also experience changes in their nipple and breast sensation. Patients may experience enhanced sensitivity, decreased sensitivity, or a complete loss of all sensation in their breasts and nipples. 

These changes may be temporary or permanent, but in many cases, especially with breast cancer survivors who have had full mastectomies, the loss of sensation is permanent. During a lumpectomy, the lymph node may also be removed; this procedure may lead to increased sensitivity in the skin surrounding the breast.

What Causes Sensitivity In Breasts And Nipples?

During mastectomies and even lumpectomies, surgeons must maneuver around the nerves in the breasts.  In the case of mastectomies, during which the entire breast is removed, the nerves that connect the breasts and nipples to the brain are severed, stretched, or cauterized.  When the nerves are cut, they can no longer send signals to the brain indicating that the breast is being stimulated. 

The nerves can also react in the opposite way, causing the breast and nipple to become extraordinarily sensitive because the nerves have been damaged and are extra stimulated.

According to the Food and Drug Administration (FDA), 30% of women who undergo breast augmentation experience some kind of change in their nipple and breast sensation.  These numbers are even higher in breast cancer survivors. 

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Types of Procedures

Generally, there are two families of procedures associated with breast, nipple, and areola reconstruction: nipple-sparing and nipple reconstruction.

  • Nipple-Sparing Reconstruction

The nipple-sparing mastectomy is a fairly new surgical procedure in the treatment of breast cancer and reconstruction.  During a nipple-sparing mastectomy, all of the breast tissue is removed, but the nipple and areola are left intact. 

Only women who are in the early stages of breast cancer are candidates for this method. The surgeon and the oncologist must ensure that all of the cancerous cells are removed during the mastectomy.  If there is a fear that some cancerous cells may be in the nipple or areola, they will have to be removed.

One side effect of this procedure is the complete loss of nipple sensation.  During the removal of the breast tissue, the surgeon is forced to sever the nerve that connects to the nipple.  After the nerve is severed, it is unlikely that feeling will return to the nipple.  

  • Complete Nipple Reconstruction 

Complete nipple reconstruction is more common than is nipple-sparing reconstruction.  During a traditional mastectomy, the surgeon will remove all of the breast tissue, including the nipple and areola, to ensure that all of the cancerous cells are removed. 

Complete nipple reconstruction is usually performed three to four months after a mastectomy and after chemotherapy is complete.

Complete nipple and areola reconstruction is an out-patient procedure performed with local anesthesia.  The surgeon will use skin grafts from other parts of the patient’s body to construct the nipple and will use a tattoo to color the areola. 

After nipple reconstruction, the nipple and the areola will not be as sensitive because they will not be connected to the original nerves in the breast.