Single-Incision Approach for Breast-Conserving Surgery: Effectiveness, Complications and Quality of Life

  • Benigno Acea-Nebril
  • Alejandra García-NovoaEmail author
  • Carmen Cereijo-Garea
  • Sergio Builes-Ramirez
  • Alberto Bouzon-Alejandro
  • Joaquín Mosquera-Oses
Breast Oncology



The aim of this study was to assess the success of tumor resection and its postoperative complications, satisfaction, and quality of life using a single-incision approach for breast-conserving surgery.

Materials and Methods

This was an observational, prospective study conducted between 2015 and 2018. The study group consisted of patients in whom tumor extirpation and lymph node (LN) staging was performed using a single incision, while the control group consisted of patients who underwent a breast-conserving procedure with independent incisions. All patients were given the preoperative and postoperative module of the Breast-Q™ questionnaire.


Overall, 226 patients met the study’s inclusion criteria, 152 of whom successfully underwent breast and LN removal using a single-incision approach (98.7% overall success). There were no significant differences in postoperative complications, although there was a greater tendency towards breast seroma in the study group and axillary neuralgia in the control group. Both groups presented a similar rate of breast and axillary salvage surgery. The postoperative Breast-Q™ questionnaire showed that the study group had greater satisfaction with both the breast and the information provided by the surgeon.


The single-incision approach is as effective as standard surgery, with custom incisions in terms of breast resection, LN staging, and complications. There was greater satisfaction with both the breast and the information provided.



The authors would like to acknowledge all members of the Breast Unit, University Hospital Complex A Coruña, A Coruña, Spain.


  1. 1.
    Fisher B, Jeong J, Anderson S, Bryant J, Fisher E, Wolmark N. Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy and total mastectomy followed by irradiation. N Engl J Med. 2002; 347:567–75.CrossRefGoogle Scholar
  2. 2.
    Veronesi U, Luini A, Del Vecchio M. Radiotherapy after breast-preserving surgery in women with localized cancer of the breast. N Eng J Med. 1993; 328:1587–91.CrossRefGoogle Scholar
  3. 3.
    Acea-Nebril B, Cereijo-Garea C, García-Novoa A, Varela-Lamas C et al. The role of oncoplastic breast reduction in the conservative management of breast cancer: complications, survival, and quality of life. J Surg Oncol. 2017;115(6):679–86.CrossRefGoogle Scholar
  4. 4.
    Nabholtz JM, Chalabi N, Radosevic-Robin N et al. Multicentric neoadjuvant pilot Phase II study of cetuximab combined with docetaxel in operable triple negative breast cancer. Int J Cancer. 2016; 138(9):2274–80.CrossRefGoogle Scholar
  5. 5.
    Giuliano AE, Ballman KV, McCall L et al. Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis: the ACOSOG Z0011 (Alliance) Randomized Clinical Trial. JAMA. 2017; 318(10):918–26.CrossRefGoogle Scholar
  6. 6.
    Acea Nebril B. “Scarless” surgery in the treatment of breast cancer. Cir Esp. 2010; 87(4):210–7.CrossRefGoogle Scholar
  7. 7.
    Spillane AJ, Brennan ME. Minimal access breast surgery: a single breast incision for breast conservation surgery and sentinel lymph node biopsy. Eur J Surg Oncol. 2009; 35(4):380–6.CrossRefGoogle Scholar
  8. 8.
    Cocilovo C, Boolbol SK, Valdes E, Feldman S. Less is more: transmammary axillary lymph node evaluation: an initial clinical experience. Am J Surg. 2006; 192(4):478–80.CrossRefGoogle Scholar
  9. 9.
    Ozaki S, Ohara M. Endoscopy-assisted breast-conserving surgery for breast cancer patients. Gland Surg. 2014; 3(2):94–108.Google Scholar
  10. 10.
    Saimura M, Mitsuyama S, Anan K et al. Endoscopy-assisted breast-conserving surgery for early breast cancer. Asian J Endosc Surg. 2013; 6(3):203–8.CrossRefGoogle Scholar
  11. 11.
    Clough KB, Kaufman GJ, Nos C, Buccimazza I, Safarti IM. Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol. 2010; 17(5):1375–91.CrossRefGoogle Scholar
  12. 12.
    Mapi Research Trust, ePROVIDE™. BREAST-Q™. Available at:
  13. 13.
    Yamashita K, Shimizu K. Transaxillary retromammary route approach of video-assisted breast surgery enables the inner-side breast cancer to be resected for breast conserving surgery. Am J Surg. 2008; 196(4):578–81.CrossRefGoogle Scholar
  14. 14.
    Park HS, Lee JS, Lee JS, Park S, Kim SI, Park BW. The feasibility of endoscopy-assisted breast conservation surgery for patients with early breast cancer. J Breast Cancer. 2011; 14(1):52–7.CrossRefGoogle Scholar
  15. 15.
    Lee EK, Kook SH, Park YL, Bae WG. Endoscopy-assisted breast-conserving surgery for early breast cancer. World J Surg. 2006; 30(6):957–64.CrossRefGoogle Scholar
  16. 16.
    Iglesias M, Gonzalez-Chapa DR. Endoscopic latissimus dorsi muscle flap for breast reconstruction after skin-sparing total mastectomy: report of 14 cases. Aesthetic Plast Surg. 2013; 37(4):719–27.CrossRefGoogle Scholar
  17. 17.
    Tukenmez M, Ozden BC, Agcaoglu O, Kecer M, Ozmen V, Muslumanoglu M, et al. Videoendoscopic single-port nipple-sparing mastectomy and immediate reconstruction. J Laparoendosc Adv Surg Tech A. 2014; 24(2):77–82.CrossRefGoogle Scholar
  18. 18.
    Noguchi M, Inokuchi M, Ohno Y, Yokoi-Noguchi M, Nakano Y, Kosaka T. Oncological and cosmetic outcome in breast cancer patients undergoing “moving window” operation. Breast Cancer Res Treat. 2011; 129(3):849–56.CrossRefGoogle Scholar
  19. 19.
    Noguchi M, Inokuchi M. “Moving window” operation for breast-conserving surgery. Breast Cancer. 2010; 17(1):56–60.CrossRefGoogle Scholar
  20. 20.
    Leidenius M, Leppänen E, Krogerus L, von Smitten K. Motion restriction and axillary web syndrome after sentinel node biopsy and axillary clearance in breast cancer. Am J Surg. 2003; 185(2):127–30.CrossRefGoogle Scholar
  21. 21.
    Moskovitz AH, Anderson BO, Yeung RS, Byrd DR, Lawton TJ, Moe RE. Axillary web syndrome after axillary dissection. Am J Surg. 2001; 181(5):434–9.CrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  1. 1.Breast UnitUniversity Hospital Complex A CoruñaA CoruñaSpain

Personalised recommendations