Abstract
BackgroundMastoscopic surgery is proven to have lower incidence of postoperative complications and better postoperative recovery than traditional breast cancer surgery. This study aimed to examine the feasibility of mastoscopic modified radical mastectomy (MRM) with skin nipple-areola preservation under air cavity-free suspension hook and stage I silicone prosthesis implantation (SMALND) compared with routine MRM.MethodsThis was a retrospective study of patients who underwent MRM for breast cancer at the Shengjing Hospital Affiliated to China Medical University between January 1, 2019, and June 30, 2019. Surgical outcomes, complications, satisfaction, and quality of life (Functional Assessment of Cancer Therapy-Breast [FACT-B] [Chinese version]) were compared between the two groups.ResultsA total of 87 patients were enrolled, with 30 underwent SMALND and 57 underwent routine MRM. The intraoperative blood loss in the SMALND group was lower than in the control group (165.3±44.1 vs. 201.4±52.7 ml, P=0.001), the operation time was longer (220.5±23.9 vs. 155.6±9.2 min, P<0.001), daily axillary drainage volume was smaller (20.2±3.6 vs. 24.1±3.0 ml, P<0.001), daily subcutaneous drainage volume was smaller (15.5±2.3 vs. 19.3±3.5 ml, P<0.001), the discharge time was shorter (7.5±1.6 vs. 9.0±1.8 days, P<0.001), and FACT-B scores were higher (83.8±5.6 vs. 72.1±4.6, P<0.001). The overall satisfaction was higher in the SMALND group than in the controls (76.7% vs. 54.4%, P=0.041). Compared with the controls, the occurrence rates of nipple and flap necrosis, upper limb edema, and paraesthesia in the SMALND group were lower within 6 months (all P<0.05).ConclusionsCompared with traditional MRM, SMALND had better surgical outcomes, higher satisfaction, higher quality of life, and lower complication rates.
Highlights
Mastoscopic surgery is proven to have lower incidence of postoperative complications and better postoperative recovery than traditional breast cancer surgery
[10], 2) N0 or N1 disease by clinical examination, ultrasound, mammography, and magnetic resonance imaging (MRI) [10], 3) refused breast-conserving surgery (BCS) or had contraindications to BCS, 4) indications for mastoscopic modified radical mastectomy (MRM) with skin nipple-areola preservation combined with stage I prosthesis implantation under air cavity-free suspension hook (patients with indications for conventional axillary lymph node dissection (ALND), no history of axillary surgery, clinical examination, ultrasound, mammography, and magnetic resonance imaging (MRI) showing N0-N1, and swollen lymph nodes had no adhesion with blood vessels and nerves), and 5) intraoperative frozen section of the areola and glands under the areola indicated no cancer cell infiltration
This study aimed to examine the feasibility of mastoscopic MRM with skin nipple-areola preservation under air cavity-free suspension hook and stage I silicone prosthesis implantation compared with routine MRM
Summary
Mastoscopic surgery is proven to have lower incidence of postoperative complications and better postoperative recovery than traditional breast cancer surgery. This study aimed to examine the feasibility of mastoscopic modified radical mastectomy (MRM) with skin nipple-areola preservation under air cavity-free suspension hook and stage I silicone prosthesis implantation (SMALND) compared with routine MRM. It is not an essential organ, the breast is important for women’s appearance, quality of life, and psychological health [1, 2]. Traditional modified radical mastectomy (MRM) significantly increases the occurrence of complications such as upper limb edema and paraesthesia, and the surgical scar from on the chest and the axilla will affect the esthetics and limit the movement of the shoulder joint to some extent [10]
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