Comparing outcomes of single-port insufflation endoscopic breast-conserving surgery and conventional open approach for breast cancer

Abstract

Background In the surgical treatment of breast cancer, the goal of surgeons is to continually create and improve minimally invasive surgical techniques to increase patients’ quality of life. Currently, routine breast-conserving surgery is often performed using two obvious incisions. Here, we compare the clinical efficacy and aesthetic outcomes of a novel technique using one incision, called ‘single-port insufflation endoscopic breast-conserving surgery’ (SIE-BCS), vs. conventional breast-conserving surgery (C-BCS) in patients with early-stage breast cancer. Methods A total of 180 patients with stage I or stage II breast cancer participated in this study, of whom 63 underwent SIE-BCS and 117 underwent C-BCS. Logistic regression analysis was conducted to assess the risk of local recurrence and metastasis. Aesthetic outcomes were evaluated using the BREAST-Q scale. Results The mean operation time was significantly longer for SIE-BCS (194.9 ± 71.5 min) than for C-BCS (140.3 ± 56.9 min), but the mean incision length was significantly shorter for SIE-BCS than for C-BCS (3.4 ± 1.2 cm vs. 8.6 ± 2.3 cm). While both surgeries yielded similar BREAST-Q ratings for satisfaction with breasts and sexual well-being, SIE-BCS was associated with significantly better ratings for physical well-being (chest area) and psychological well-being. Additionally, SIE-BCS was associated with decreased rates of adverse effects of radiation. The preliminary analysis showed that SIE-BCS did not increase the risk of local recurrence or metastasis. Conclusion The novel single-port insufflation endoscopic assisted BCS technique is feasible, safe, and improves patients’ postoperative comfort and psychological well-being, as compared to the conventional technique.

A Retrospective Study of the Dual-Main Surgeons’ Endoscopy-Assisted Insufflation Bilateral Nipple-Sparing Mastectomy with Immediate Implant Reconstruction

“…It is also confirmed that EABS has a better result of blood loss, wound length, and cosmetic satisfaction than CBS and is named "aesthetic scar-less" surgery [8,13,15]. Normally, EABS has longer operation time, longer hospital stays, and more cost, which limits its development and application [6,7,14]. However, after several cases of practice, the operation time decreases a lot [8,15,16] and DMS-EABS can also be a good way to reduce operation time and blood loss as shown in (Table 2).…”

“…Therefore, doctors pay attention to the aesthetic results and quality of life, and minimally invasive EABS has become the current trend. With inconspicuous incisions, magnified view, and clear vision, EABS is widely used for benign and malignant breast disease treatment [6,7]. Endoscopyassisted BCS [6] and endoscopy-assisted nipple-sparing mastectomy (NSM) or skin-sparing mastectomy (SSM) with immediate implant reconstruction (IIR) [3,8] are popular breast cancer surgery.…”

Single-port three-dimensional (3D) endoscopic-assisted breast surgery—preliminary results and patient-reported satisfaction in 145 breast cancer and gynecomastia cases

“…In terms of S-P 3D E-BCS, it seems to have a longer operative time, but offers better cosmetic outcomes compared to conventional BCS in previous studies [ 42 – 48 ]. However, there is a lack of a large study comparing endoscopic and conventional BCS.…”