Conventional vs Minimal Invasive Breast Surgery

Abstract

To the Editor Wan and colleagues 1 found that there was little to no differences in the long-term outcomes between minimal access breast surgery (MABS) and conventional breast surgery in their institution. We have 3 questions about this research.First, we are interested about the infrastructure and chronological changes in the authors' institution. Given that the study period ranged 13 years, the type of equipment they used and their changes may have influenced the study results over time. Furthermore, we would also like to ask if they may have encountered any hardships due to the use of certain novel equipment. 2 In recent years, the field of robotic-assisted surgery has been vastly changing, and the same results may not be reproduced in other institutions without the same or more updated technology. 3 Second, we are interested in whether the surgeons' experience may have affected the outcomes of the surgery. MABS is not a common surgery in many places of the world. Thus, both in laparoscopic surgeries and in robot-assisted surgery, the experience of the surgeon is considered to be extremely important. 4 Since the experience of the surgeon can be an influential factor for the outcomes, it would be useful to take into account the factor of each operator according to their years of practice and number of MABS completed.The third is about the cost of the surgery, which can be one of the biggest drawback of MABS. Several recent studies indicated that the cost for surgery is significantly different between conventional and robot-assisted surgery. 5 Furthermore, it is plausible that patients who could receive the more expensive surgery are financially privileged and have more resources, resulting in a selection bias between these operations.