NCT06094257

Brief Summary

During breast surgery, sensory nerves are cut which may lead to reduced sensation and pain. Surgical reinnervation techniques have been developed with the aim of improving postoperative sensation by preserving the nerves and connecting them to the nipple and areola. The investigators aim to compare postoperative sensation and patient reported outcomes in patients undergoing reinnervation versus those not undergoing reinnervation to determine if there is a difference. The investigators will investigate this in patients undergoing gender-affirming mastectomy, implant-based breast reconstruction and autologous breast reconstruction. The investigators will use various tools that measure sensation quantitatively.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
400

participants targeted

Target at P75+ for all trials

Timeline
83mo left

Started Feb 2022

Longer than P75 for all trials

Geographic Reach
1 country

2 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress38%
Feb 2022Mar 2033

Study Start

First participant enrolled

February 9, 2022

Completed
1.6 years until next milestone

First Submitted

Initial submission to the registry

October 3, 2023

Completed
20 days until next milestone

First Posted

Study publicly available on registry

October 23, 2023

Completed
9.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2033

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2033

Last Updated

August 27, 2025

Status Verified

August 1, 2025

Enrollment Period

11.1 years

First QC Date

October 3, 2023

Last Update Submit

August 26, 2025

Conditions

Keywords

SensationReinnervationPeripheral nerveReconstructionBreast reinnervationChest reinnervationGender-affirming mastectomyBreast reconstructionPeripheral nerve repairTargeted nipple areolar complexTargeted nipple areolar complex reinnervation

Outcome Measures

Primary Outcomes (11)

  • Change in Breast Q scores

    All BREAST-Q scores range from 0-100. The scores are computed from the responses to the separate questions by adding them together and converting the score to a scale from 0 to 100 (similar to conversion into a percentage). A higher score means high satisfaction or better health-related quality of life.

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in Gender-Q scores

    All Gender-Q scores range from 0-100. The scores are computed from the responses to the separate questions by adding them together and converting the score to a scale from 0 to 100 (similar to conversion into a percentage). A higher score means high satisfaction or better health-related quality of life.

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in cold detection threshold

    Thermal detection measured by Medoc TSA system

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in warm detection threshold

    Thermal detection measured by Medoc TSA system

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in heat pain threshold

    Thermal detection measured by Medoc TSA system

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in mechanical detection threshold

    Measured by MRC Opti Hair von Frey Filaments

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in two-point discrimination

    Measured by MRC Opti Hair von Frey Filaments

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in mechanical pain threshold

    Measured by MRC Pinprick Stimulator

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in pressure pain threshold

    Measured by Medoc Pressure algometer

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in Tinel sensation

    Measure on physical exam

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

  • Change in vibration sensation

    Measured by tuning fork

    preoperative, postoperative at 1 month, 3 months, 6 months, and 1 year

Secondary Outcomes (11)

  • Change in Breast Q scores long term

    Annually at 2-10 years post-operation

  • Change in Gender Q scores long term

    Annually at 2-10 years post-operation

  • Change in vibration sensation

    Annually at 2-10 years post-operation

  • Change in Tinel sensation

    Annually at 2-10 years post-operation

  • Change in pressure pain threshold

    Annually at 2-10 years post-operation

  • +6 more secondary outcomes

Study Arms (4)

Nipple sparing mastectomy (NSM) and implant reconstruction

Nipple sparing mastectomy (NSM) and implant reconstruction

Diagnostic Test: Sensory testing

Nipple sparing mastectomy (NSM) and autologous reconstruction

Nipple sparing mastectomy (NSM) and autologous reconstruction

Diagnostic Test: Sensory testing

Gender mastectomy with free nipple grafting

Gender mastectomy with free nipple grafting

Diagnostic Test: Sensory testing

Control patients matched by surgical procedure, age, BMI and mastectomy weight.

Control patients matched by surgical procedure, age, BMI and mastectomy weight.

Diagnostic Test: Sensory testing

Interventions

Sensory testingDIAGNOSTIC_TEST

Quantitative sensory testing (QST) will be performed. QST was developed to standardize the noninvasive assessment of the somatosensory nervous system and quantify functioning of all aspects of sensation (light touch, pressure, warm, cold, pain, vibration): 1. Thermal detection (Medoc TSA system): Cold detection threshold B) Warm detection threshold C) Heat pain threshold 2. Mechanical detection threshold (MRC Opti Hair von Frey Filaments) 3. Two-point discrimination (MRC Opti Hair von Frey Filaments) 4. Mechanical pain threshold (MRC Pinprick Stimulator) 5. Pressure pain threshold (Medoc Pressure algometer) 6. Tinel sign on physical exam 7. Vibration (tuning fork)

Control patients matched by surgical procedure, age, BMI and mastectomy weight.Gender mastectomy with free nipple graftingNipple sparing mastectomy (NSM) and autologous reconstructionNipple sparing mastectomy (NSM) and implant reconstruction

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodProbability Sample
Study Population

Massachusetts General Hospital (MGH) and Weill Cornell Medicine (WCM) are ideally suited for enrollment of patients in this study. Both institutions are high-volume center of expertise for gender affirming mastectomy and breast reconstructions as well as peripheral nerve surgery. Patients will be matched by BMI, age and mastectomy weight. Patients scheduled to undergo gender affirming mastectomy or breast reduction surgery at MGH and WCM will be evaluated for the study and will be presented with the option to hear about the study by our research assistant. Those interested in the study will be presented with all the necessary details required by the IRB including a study fact sheet. Verbal consent will be obtained and documented.

You may qualify if:

  • Age over 18
  • Patient is scheduled for gender mastectomy surgery (including nipple sparing mastectomy and mastectomy with free nipple graft) or NSM with breast implant or autologous reconstruction
  • Patient is capable and willing to provide informed consent

You may not qualify if:

  • Patient has a nerve condition that does not allow for assessment of sensation
  • Currently prescribed medication known to impact nerve regeneration or to cause peripheral neuropathy
  • Bilateral reconstruction with non-uniform treatment (i.e. 1 reconstructed breast is non-neurotized, 1 reconstructed breast is neurotized)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

RECRUITING

Weill Cornell Medicine

New York, New York, 10065, United States

RECRUITING

MeSH Terms

Conditions

Sensation DisordersPhantom LimbPain, PostoperativeChronic PainHypesthesia

Condition Hierarchy (Ancestors)

Neurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and SymptomsPerceptual DisordersNeurobehavioral ManifestationsPostoperative ComplicationsPathologic ProcessesPainSomatosensory Disorders

Study Officials

  • Lisa Gfrerer, MD, PhD

    Weill Medical College of Cornell University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Lisa Gfrerer, MD, PhD

CONTACT

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

October 3, 2023

First Posted

October 23, 2023

Study Start

February 9, 2022

Primary Completion (Estimated)

March 1, 2033

Study Completion (Estimated)

March 1, 2033

Last Updated

August 27, 2025

Record last verified: 2025-08

Locations