Technical Feasibility and Cosmetic Advantage of Hybrid Endoscopy-Assisted Breast-Conserving Surgery for Breast Cancer Patients

Abstract

Hybrid EBCS can provide sufficient free margin, and its surgical curability is acceptable. Additionally, this method is superior to CBCS in terms of cosmetic outcome.

Endoscopy Assisted Oncoplastic Breast Surgery (EAOBS)

“…The skin, pectoral muscle and chest wall invasions are contraindications. It cannot be performed in cases of multifocal tumors (1,2). The exclusion criteria include tumor close to skin, thoracic deformity, hemorrhagic diathesis, elderly age, poor health condition and patient's reluctance towards this method (3).…”

“…The other limitations of breast-conserving surgery are applicable for this, as well. Some studies cited clinically positive axilla as a contraindication (1)(2)(3)(4)(5)(6)(7). There are also studies limiting the technique to cases that would have less than 20% of volume loss 1,8).…”

“…Some studies cited clinically positive axilla as a contraindication (1)(2)(3)(4)(5)(6)(7). There are also studies limiting the technique to cases that would have less than 20% of volume loss 1,8). If the potential loss of volume in the breast is estimated at 20-40%, volume replacement techniques may be more appropriate in place of volume displacement method (1,(9)(10)(11).…”

“…Also, the location of tumor is important, too. For tumors located in the inner or lower part of the breast, the spaces to emerge following excision have to be filled in via volume displacements through periareolar and axillary incision (1,8). Oil necrosis may be frequent especially when reconstruction is performed with wide-ranging mobilization and volume displacement in old patients with low breast density (1,8,11,12).…”

“…The excision margins are determined at 1-2 cm away from the tumor margins (1,3,(6)(7)(8)(9)16). At the beginning of surgery, all-round color stain injections are performed at the excision margins (1,4,8,11) (Figure 2). Since the blue stain is generally used for marking sentinel lymph nodes, the marking should be done using a stain that is not mixed with the blue stain in EAO-BCS.…”