A new method of measuring temperature discrimination of the breast, and what to expect in the preoperative breast patient.

[BACKGROUND] Temperature sensitivity and discrimination of reconstructed breasts are important for the protection and longevity of reconstruction. There is a paucity of literature assessing the impact of breast surgeries on temperature discrimination of the breast and nipple-areolar complex (NAC), and studies are limited by testing methodologies. A new method was developed to address these limitations.

[METHODS] This study included preoperative data from a prospective database of patients presenting for an initial consultation for immediate breast reconstruction or reduction. McKesson cold and hot compresses were held against the skin in the superior, medial, lateral, and inferior breast quadrants and the NAC. Patients were instructed to respond with "hot," "cold," or "unsure." The correct responses were scored as +1, incorrect responses as -1, and temperature insensitivity as 0.

[RESULTS] Fifty-nine patients (118 breasts) were tested preoperatively: 43 patients (86 breasts) presented for reconstruction and 16 patients (32 breasts) for reduction. Nine patients in the reconstruction group and 2 patients in the reduction group had prior breast surgery, including augmentation, prior reduction, and lumpectomy or excisional biopsy. Multivariate analysis identified prior breast surgery to be independently associated with temperature insensitivity or incorrect sensitivity (odds ratio = 6.51, p = 0.04). There were no incorrect identifications of the hot compress, whereas 5 of 118 breasts had incorrect identifications of the cold compress.

[CONCLUSION] This temperature discrimination methodology is cost-and time-effective with reliable and reproducible reporting. Breast surgery may preferentially impact cold over hot sensitivity.