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Endoscopy-assisted Breast-Conserving Surgery for Early Breast Cancer

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Abstract

Purpose

Breast-conserving surgery is now accepted as one of the standard therapeutic options for stages I and II breast cancers. Although breast-conserving surgery can help retain a good breast shape, a long marked scar would be a disadvantage. Endoscopic surgery can be performed via a small and remote incision that becomes inconspicuous after surgery. To improve the cosmetic outcome, endoscopic breast-conserving surgery, which can be performed through minimal axillary and periareolar semicircular incisions, was undertaken.

Methods and materials

From October 2002 to October 2004, 20 breast cancer patients whose tumor sizes were less than 3 cm and who were clinically node negative without invasion to the skin and pectoralis major muscle underwent endoscopic breast-conserving surgery. First, endoscopic dye-guided sentinel node biopsy was done through a low transverse axillary incision lateral to the pectoralis major muscle. The subpectoral pocket was gently created by Vein Harvest under the view of endoscopic monitor. We made the periareolar semicircular incision to create the skin flap and to resect the tumor-containing quadrant by using Visiport and PowerStar scissors. Frozen-section biopsies were done to rule out tumor invasion to the resection margin. Patient characteristics, tumor characteristics, operation time, and amount of bleedings were all evaluated.

Results

The mean age of patients was 45 (range: 25–64). The mean tumor size was 2.2 cm (range: 0.2–4.0 cm). The average operation time of the early 9 cases, except the 3 cases that underwent axillary-node dissection, was 178 minutes, and that of the later 8 cases was 130 minutes (P < 0.001). The mean amount of operative bleeding was 184 ± 130 ml. There were no major complications.

Conclusion

Endoscopic breast-conserving surgery is a new technique that can minimize the long operation scar of classic breast-conserving surgery. In properly selected cases, our results showed the maximized cosmetic satisfaction of the breast cancer patients and a shortened operation time after the learning period, promising it could be an alternative to the classic breast-conserving surgery.

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Authors and Affiliations

  1. Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyung-Dong, Jongro-Ku, Seoul, 110-746, Korea

    Eun-Kyu Lee, Yong-Lai Park & Won-Gil Bae

  2. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108,Pyung-Dong, Jongro-Ku, Seoul, 110-746, Korea

    Shin-Ho Kook

Authors
  1. Eun-Kyu Lee
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  2. Shin-Ho Kook
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  3. Yong-Lai Park
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  4. Won-Gil Bae
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Corresponding author

Correspondence to Won-Gil Bae.

Additional information

This paper is to be presented as a video-mode presentation for the 41st World Congress of Surgery at the International Surgical Society/Societe Internationale de Chirurgie (August 21–25, 2005, Durban, South Africa)

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Lee, EK., Kook, SH., Park, YL. et al. Endoscopy-assisted Breast-Conserving Surgery for Early Breast Cancer. World J. Surg. 30, 957–964 (2006). https://doi.org/10.1007/s00268-005-0202-y

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