Abstract P4-13-04: Robotic nipple-sparing mastectomy with immediate prosthetic breast reconstruction : A preliminary study

Abstract

Abstract Background: Robotic nipple-sparing mastectomy (RNSM) could be a significant advancement in the treatment of selected breast cancers and prophylaxis. The aim of this prospective study was to assess feasibility of the RNSM with immediate prosthetic breast reconstruction (IPBR) on the first 50 consecutive cases performed in Gustave Roussy. Methods: RNSM with IPBR was offered to patients with breast cup size A, B or C and ptosis grade ≤ 2. In case of oncologic surgery, RNSM was offered only if the patient fulfilled oncological indications for NSM (NAC). In case of prophylactic surgery, RNSM was offered only if a high-risk genetic mutation had been identified or if the patient was at high risk of breast cancer. The primary endpoint was the conversation rate to open technique. The duration of the surgery, the rate of postoperative complications, the length of the scar, the duration of drainage and hospital stay, the rate and duration of rehospitalization were also analyzed. Results: Of 50 RNSM with IPBR from December 2015 to April 2017, 1 case of conversion to open technique occurred (2%) because of an uncontrolled bleeding from an internal mammary perforator. Two infections occurred (4%) : one led to implant loss. There were no cases of mastectomy skin flap or NAC necrosis. No other major complications were observed. The duration of the whole procedure was reduced gradually from 214 min to 86 min. Length of scar was between 2.5 and 5 cm. Patients were discharged home between the 4th and the 10th postoperative day after the removal of the drain. Conclusion: Preliminary data attest to the feasibility, the reproducibility and the safety of this approach. However, long-term data are needed to confirm the reduced rate of skin and NAC necrosis compared to the open technique, the oncological safety and the aesthetic stability of the result. Citation Format: Sarfati B, Struk S, Leymarie N, Honart JF, Rimareix F, Delaloge S, Saghatchian M, Ghouadni A, Alkhashnam H, Mazouni C, Kolb F. Robotic nipple-sparing mastectomy with immediate prosthetic breast reconstruction : A preliminary study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-13-04.