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Safety and Feasibility of Minimally Invasive (Laparoscopic/Robotic-Assisted) Nipple-Sparing Mastectomy Combined with Prosthesis Breast Reconstruction in Breast Cancer: A Single-Center Retrospective Study

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Minimally invasive (robotic or laparoscopic-assisted) nipple-sparing mastectomy combined with prosthesis breast reconstruction (NSM–PBR) is associated with smaller scars and greater patient satisfaction. However, the oncological safety of minimally invasive NSM–PBR remains controversial.

Patients and Methods

This was a retrospective study of patients with breast cancer who underwent breast reconstruction between 1 January 2006 and 20 February 2021. Demographic and clinicopathological characteristics, operation information, postoperative complications, and survival outcomes were analyzed.

Results

In all, 292 patients underwent minimally invasive NSM–PBR and 205 underwent open NSM–PBR for breast cancer. In the minimally invasive NSM–PBR group, 268 (91.8%) patients underwent laparoscopy and 24 (8.2%) patients underwent robot-assisted NSM–PBR. Mean operation time in the minimally invasive NSM–PBR group was significantly longer than that in the open NSM–PBR group (P = 0.023). Mean intraoperative blood loss was significantly less in the minimally invasive NSM–PBR group (P < 0.05). There was no significant between-group difference in total complications. Similarly, there were no significant between-group differences in overall survival, recurrence-free survival, and local recurrence rate (P = 0.450, P = 0.613, and P = 0.679, respectively).

Conclusions

The complication, recurrence, and mortality rates in minimally invasive NSM–PBR group were comparable to those in open NSM–PBR group. Our preliminary results are encouraging and suggest that minimally invasive NSM–PBR affords good cosmetic results and its oncological safety is comparable to that of open surgery.

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References

  1. Lin W, Yang Y, Zhong W, et al. The effect of low and high vacuum drainage on the postoperative drainage of breast cancer: insights from a prospective, non-inferiority, randomized clinical trial. Cancer Manag Res. 2020;12:12487–96.

    Article  Google Scholar 

  2. Gui Y, Liu X, Chen X, et al. A network meta-analysis of surgical treatment in patients with early breast cancer. J Natl Cancer Inst. 2019;111(9):903–15.

    Article  Google Scholar 

  3. O’Connell RL, Rattay T, Dave RV, et al. The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study. Br J Cancer. 2019;120(9):883–95.

    Article  Google Scholar 

  4. Huang CJ, Hou MF, Lin SD, et al. Comparison of local recurrence and distant metastases between breast cancer patients after postmastectomy radiotherapy with and without immediate TRAM flap reconstruction. Plast Reconstr Surg. 2006;118(5):1079–86.

    Article  CAS  Google Scholar 

  5. Shen Z, Sun J, Yu Y, et al. Oncological safety and complication risks of mastectomy with or without breast reconstruction: a Bayesian analysis. J Plast Reconstr Aesthet Surg. Sep 20 2020.

  6. Ito K, Kanai T, Gomi K, et al. Endoscopic-assisted skin-sparing mastectomy combined with sentinel node biopsy. ANZ J Surg. 2008;78(10):894–8.

    Article  Google Scholar 

  7. Ozaki S, Ohara M. Endoscopy-assisted breast-conserving surgery for breast cancer patients. Gland Surg. 2014;3(2):94–108.

    PubMed  PubMed Central  Google Scholar 

  8. Toesca A, Invento A, Massari G, et al. Update on the feasibility and progress on robotic breast surgery. Ann Surg Oncol. 2019;26(10):3046–51.

    Article  Google Scholar 

  9. Toesca A, Sangalli C, Maisonneuve P, et al. A Randomized trial of robotic mastectomy versus open surgery in women with breast cancer or BRCA mutation. Ann Surg. 2021. https://doi.org/10.1097/SLA.0000000000004969.

    Article  PubMed  Google Scholar 

  10. Ramirez PT, Frumovitz M, Pareja R, et al. Minimally invasive versus abdominal radical hysterectomy for cervical cancer. N Engl J Med. 2018;379(20):1895–904.

    Article  Google Scholar 

  11. Jiang J, Yang XH, Fan LJ, Zhang Y, Zhang F, Zhou Y. Application of endoscopy-assistant operation in surgical treatment of breast diseases. Zhonghua Yi Xue Za Zhi. 2005;85(3):181–3.

    PubMed  Google Scholar 

  12. Du J, Mo H, Fan L, Jiang J. Robot-assisted internal mammary lymph chain excision for breast cancer: a case report. Medicine. 2017;96(35):e7894.

    Article  Google Scholar 

  13. Yarnold J. Early and locally advanced breast cancer: diagnosis and treatment National Institute for Health and Clinical Excellence guideline 2009. Clin Oncol. 2009;21(3):159–60.

    Article  CAS  Google Scholar 

  14. Yang JD, Lee J, Lee JS, Kim EK, Park CS, Park HY. Aesthetic scar-less mastectomy and breast reconstruction. J Breast Cancer. 2021;24(1):22–33.

    Article  Google Scholar 

  15. Lai HW, Chen ST, Chen DR, et al. Current trends in and indications for endoscopy-assisted breast surgery for breast cancer: results from a six-year study conducted by the Taiwan Endoscopic Breast Surgery Cooperative Group. PloS One. 2016;11(3):e0150310.

    Article  Google Scholar 

  16. Davila AA, Mioton LM, Chow G, et al. Immediate two-stage tissue expander breast reconstruction compared with one-stage permanent implant breast reconstruction: a multi-institutional comparison of short-term complications. J Plast Surg Hand Surg. 2013;47(5):344–9.

    Article  Google Scholar 

  17. Wattoo G, Nayak S, Khan S, et al. Long-term outcomes of latissimus dorsi flap breast reconstructions: a single-centre observational cohort study with up to 12 years of follow up. J Plast Reconstr Aesthet Surg. 2021;74(9):2202–9.

    Article  CAS  Google Scholar 

  18. Lee D, Jung BK, Roh TS, Kim YS. Ultrasonic dissection versus electrocautery for immediate prosthetic breast reconstruction. Arch Plast Surg. 2020;47(1):20–5.

    Article  Google Scholar 

  19. Kitamura K, Ishida M, Inoue H, Kinoshita J, Hashizume M, Sugimachi K. Early results of an endoscope-assisted subcutaneous mastectomy and reconstruction for breast cancer. Surgery. 2002;131(1 Suppl):S324–9.

    Article  Google Scholar 

  20. Lai HW, Chen ST, Mok CW, et al. Robotic versus conventional nipple sparing mastectomy and immediate gel implant breast reconstruction in the management of breast cancer—a case control comparison study with analysis of clinical outcome, medical cost, and patient-reported cosmetic results. J Plast Reconstr Aesthet Surg. 2020;73(8):1514–25.

    Article  Google Scholar 

  21. Lai HW, Wang CC, Lai YC, et al. The learning curve of robotic nipple sparing mastectomy for breast cancer: an analysis of consecutive 39 procedures with cumulative sum plot. Eur J Surg Oncol. 2019;45(2):125–33.

    Article  Google Scholar 

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Funding

This work was supported by the Chongqing Technology Innovation and Application Development Project (no. cstc2019jscx-msxmX0191) and grants from the National Key Research and Development Program of China (no. 2018YFC1707503).

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Author notes

  1. Yu Gui and Qingqiu Chen These authors contributed equally to this work.

Authors and Affiliations

  1. Breast Disease Center, Southwest Hospital, Army Medical University, Chongqing, China

    Yu Gui MD, Qingqiu Chen MD, Shichao Li MD, PhD, Xi Yang MD, Jing Liu MD, Xin Wu MM, Linjun Fan MD, PhD, Jun Jiang MD, PhD & Li Chen MD, PhD

  2. Tabor Academy, Marion, USA

    Yilin Zhu BD

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  1. Yu Gui MD
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  2. Qingqiu Chen MD
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  8. Linjun Fan MD, PhD
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Correspondence to Li Chen MD, PhD.

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Gui, Y., Chen, Q., Li, S. et al. Safety and Feasibility of Minimally Invasive (Laparoscopic/Robotic-Assisted) Nipple-Sparing Mastectomy Combined with Prosthesis Breast Reconstruction in Breast Cancer: A Single-Center Retrospective Study. Ann Surg Oncol 29, 4057–4065 (2022). https://doi.org/10.1245/s10434-022-11420-8

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  • DOI: https://doi.org/10.1245/s10434-022-11420-8

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