World Journal of Surgery

, Volume 41, Issue 8, pp 2020–2025 | Cite as

Bilateral Axillo-Breast Approach Robotic Thyroidectomy (BABA RT) Does Not Interfere with Breast Image Follow-Up

  • Hyeong Won Yu
  • Young Jun Chai
  • Hyungju Kwon
  • Su-jin Kim
  • June Young Choi
  • Kyu Eun LeeEmail author
Original Scientific Report



Bilateral axillo-breast approach robotic thyroidectomy (BABA RT) is frequently performed and has excellent cosmetic results. However, there has been concern that subcutaneous tunneling in construction of the operation field might interfere with subsequent breast imaging. In this study, we evaluated whether BABA RT interferes with breast imaging by evaluating serial perioperative results of mammography and ultrasonography.


We selected female patients who underwent BABA RT between 2008 and 2012, and who also had mammography or ultrasonography pre- and postoperatively, and compared the results of pre- and postoperative imaging. The results of mammography and ultrasonography were reported according to the Breast Imaging Reporting and Data System (BIRADS).


A total of 175 nodules from 108 female patients were analyzed. The mean age of the patients was 42.9 ± 9.7 years, and the median follow-up period was 34.1 months. Ninety-four patients (87.0%) underwent total thyroidectomy, and 101 patients (93.5%) had malignant thyroid disease. After BABA RT, mammography and ultrasonography were performed an average of 2.9 ± 2.0 times and 3.3 ± 2.0 times per person, respectively. Six patients required breast intervention according to mammography or ultrasonography after BABA RT, and all procedures were successfully conducted.


BABA RT did not cause diagnostic difficulties such as poor sonic window in subsequent breast imaging studies. Routine breast imaging studies for breast nodule follow-up could be performed without difficulties resulting from BABA RT.


Breast Imaging Endoscopic Thyroidectomy Subcutaneous Tunneling Breast Nodule Malignant Thyroid Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning, Republic of Korea (Grant Number: 2015R1C1A1A01055464).

Compliance with ethical standards

Conflicts of interest

The authors have no conflicts of interest or financial ties to disclose.


  1. 1.
    Pellegriti G, Frasca F, Regalbuto C et al (2013) Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. J Cancer Epidemiol 2013:965212. doi: 10.1155/2013/965212 PubMedPubMedCentralGoogle Scholar
  2. 2.
    Jung KW, Won YJ, Kong HJ et al (2014) Cancer statistics in Korea: incidence, mortality, survival and prevalence in 2011. Cancer Res Treat 46:109–123. doi: 10.4143/crt.2014.46.2.109 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Lee KE, Kim E, Koo DH et al (2013) Robotic thyroidectomy by bilateral axillo-breast approach: review of 1026 cases and surgical completeness. Surg Endosc Other Interv Tech 27:2955–2962. doi: 10.1007/s00464-013-2863-1 CrossRefGoogle Scholar
  4. 4.
    Lee KE, Koo DH, Kim SJ et al (2010) Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach. Surgery 148:1207–1213. doi: 10.1016/j.surg.2010.09.018 CrossRefPubMedGoogle Scholar
  5. 5.
    Kim SJ, Lee KE, Myong JP et al (2011) Recovery of sensation in the anterior chest area after bilateral axillo-breast approach endoscopic/robotic thyroidectomy. Surg Laparosc Endosc Percutan Tech 21:366–371. doi: 10.1097/SLE.0b013e31822dd24f CrossRefPubMedGoogle Scholar
  6. 6.
    Kwon H, Koo DH, Choi JY et al (2013) Bilateral axillo-breast approach robotic thyroidectomy for graves’ disease: an initial experience in a single institute. World J Surg 37:1576–1581. doi: 10.1007/s00268-013-2027-4 CrossRefPubMedGoogle Scholar
  7. 7.
    Choi JY, Lee KE, Chung KW et al (2012) Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA): review of 512 cases in a single institute. Surg Endosc Other Interv Tech 26:948–955. doi: 10.1007/s00464-011-1973-x CrossRefGoogle Scholar
  8. 8.
    Bittner RB (2010) Guide to mammography reports: BI-RADS terminology. Am Fam Physician 82:114–115PubMedGoogle Scholar
  9. 9.
    Macéa JR, Fregnani JHTG (2006) Anatomy of the thoracic wall, axilla and breast. Int J Morphol 24:691–704. doi: 10.4067/S0717-95022006000500030 CrossRefGoogle Scholar
  10. 10.
    Kim SM, Park JM (2004) Mammographic and ultrasonographic features after autogenous myocutaneous flap reconstruction mammoplasty. J Ultrasound Med 23:275–282CrossRefPubMedGoogle Scholar
  11. 11.
    Pinel-Giroux FM, El Khoury MM, Trop I et al (2013) Breast reconstruction: review of surgical methods and spectrum of imaging findings. Radiographics 33:435–453CrossRefPubMedGoogle Scholar
  12. 12.
    Sim YT, Litherland JC (2012) The use of imaging in patients post breast reconstruction. Clin Radiol 67:128–133. doi: 10.1016/j.crad.2011.07.050 CrossRefPubMedGoogle Scholar
  13. 13.
    Thomson JG, Liu Y-J, Restifo RJ et al (2009) Surface area measurement of the female breast: phase I. Validation of a novel optical technique. Plast Reconstr Surg 123:1588–1596. doi: 10.1097/PRS.0b013e3181a076ad CrossRefPubMedGoogle Scholar
  14. 14.
    Masroor I (2008) Effectiveness of assigning BI-RADS category-3 to breast lesion with respect to follow-up. J Coll Physicians Surg Pakistan 18:209–212Google Scholar
  15. 15.
    Alimoglu E, Alimoglu MK, Ceken K et al (2011) Bi-RADS category 3 nonpalpable breast masses on sonography: long-term results of a prospective cohort study. J Clin Ultrasound 40:125–134. doi: 10.1002/jcu.21894 CrossRefGoogle Scholar
  16. 16.
    Brenner RJ, Vinstein L, Bein E, Sarti A (1994) Spontaneous regression of interval benign cysts of the breast. Radiology 193(2):365–368CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Hyeong Won Yu
    • 1
    • 4
  • Young Jun Chai
    • 2
    • 3
  • Hyungju Kwon
    • 1
    • 3
  • Su-jin Kim
    • 1
    • 3
  • June Young Choi
    • 3
    • 4
  • Kyu Eun Lee
    • 1
    • 3
    Email author
  1. 1.Department of SurgerySeoul National University Hospital and College of MedicineSeoulKorea
  2. 2.Department of SurgerySeoul National University Boramae Medical CenterSeoulKorea
  3. 3.Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  4. 4.Department of SurgerySeoul National University Bundang HospitalSeongnam-siKorea

Personalised recommendations