PurposeIn the surgical treatment of breast cancer, the goal of surgeons is to continuously create and improve minimally invasive surgical methods to increase the quality of life of the patient. Currently, routine breast-conserving surgery is performed using two obvious incisions. Here, we compare the clinical efficacy and aesthetic perspectives between a novel technique using one incision called single-port insufflation endoscopic breast-conserving surgery and conventional breast-conserving surgery in early stage breast cancer.MethodsA total of 180 patients with stage I or stage II breast cancer participated in this study. Single-port insufflation endoscopic breast-conserving surgery was performed on 63 patients, while conventional breast-conserving surgery was performed on 117 patients. The evaluation of the aesthetic outcome was carried out by the BREAST-Q scale. Logistic regression was conducted to assess the risk of local recurrence and metastasis.ResultsThere were significant differences between the two groups for chest well-being, psychological well-being, and adverse effects of radiation. The scores for satisfaction of breasts and sexual well-being showed no statistical differences between the two groups. There was no statistical significance in local recurrence or metastasis between the two groups. Single-port insufflation endoscopic breast-conserving surgery did not increase the risk of local recurrence or metastasis.ConclusionThe novel surgical technique, single-port insufflation endoscopic breast-conserving surgery, is a feasible and safe surgery and has advantages in terms of cosmetic outcome and psychological status.