Abstract
BackgroundEndoscopy-assisted breast surgery (EABS), a technique that optimizes cosmetic outcome because it is performed through small wounds hidden in inconspicuous areas, could be an alternative surgical technique for benign breast tumors. In this study, we report the preliminary results of 323 EABS procedures performed at our institution for the management of benign breast tumors.MethodsThe medical records of patients who underwent EABS for benign breast lesions during the periods August 2010 to December 2015 were collected from the Changhua Christian Hospital EABS database. Data on clinicopathologic characteristics, type of surgery, hospital stay, and complications were analyzed to determine the effectiveness of the procedure for benign breast tumors. The operating time with the number of procedure performed was analyzed for learning curve evaluation. Patient satisfaction with cosmetic outcome was evaluated with a self-report questionnaire.ResultsA total of 323 EABS procedures were performed in 286 patients with benign breast lesions, including 249 (90.5%) patients with unilateral lesions. The mean age was 36 years, the mean tumor size was 2.2 cm, and the mean distance from the nipple to the tumor was 5.2 cm. Most (93.8%, 303/323) of these tumors were excised through a transareolar wound, 2.4% (8/323) through an axillary wound, and 0.3% (1/323) through the infra-mammary fold. Histopathologic analysis revealed that 63.5% (202/318) of the tumors were fibroadenoma-related lesions. The mean operative time was 81.4 min (59~89 min), which was decreased with experience increased. The overall rate of complications was 6.5%, and all were minor and wound-related. Among the 110 patients who participated in the self-report cosmetic outcome evaluation, 85.4% reported being satisfied with the cosmetic result, and almost all were satisfied with breast symmetry. Of the patients interviewed, 92.7% reported that they would choose the same procedure if they had to undergo the operation again.ConclusionsOur preliminary results show that transareolar video-assisted breast surgery is a safe and effective procedure with good cosmetic outcome and that it could be appropriate for patients with moderate to large peripherally located breast tumors.Trial registrationCCH-IRB No.15115. Registered 14 December 2015 (retrospectively registered).
Highlights
Endoscopy-assisted breast surgery (EABS), a technique that optimizes cosmetic outcome because it is performed through small wounds hidden in inconspicuous areas, could be an alternative surgical technique for benign breast tumors
On our preliminary experience performing 323 EABS procedures for the management of benign breast tumors, we present the technique of videoassisted breast surgery, the indications for surgery, the preliminary outcomes, the learning curve associated with EABS, and the patient-reported cosmetic outcomes
From August 2010 to December 2015, a total of 323 EABS procedures were performed in 286 patients; the vast majority of whom had unilateral disease (n = 249, 90.5%)
Summary
Endoscopy-assisted breast surgery (EABS), a technique that optimizes cosmetic outcome because it is performed through small wounds hidden in inconspicuous areas, could be an alternative surgical technique for benign breast tumors. We report the preliminary results of 323 EABS procedures performed at our institution for the management of benign breast tumors. Breast masses in young patients are usually benign in nature and are most commonly fibroadenomas, cysts, or fibrocystic lesions [1, 2]. The goal of surgical excision of benign breast tumors is the complete excision of the tumor with a thin rim of normal tissue [1, 5, 7]. Conventional excision is a safe and effective method for managing benign breast tumors, the procedure can result in suboptimal cosmetic outcomes such as conspicuous scars and misshapen breasts caused by cavity collapse after resection of the tumor
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