Abstract
Breast cancer is worldwide the most common cause of cancer in women and causes the second most common cancer-related death. Nipple-sparing mastectomy (NSM) is commonly used in therapeutic and prophylactic settings. Furthermore, (preventive) mastectomies are, besides complications, also associated with psychological and cosmetic consequences. Robotic NSM (RNSM) allows for better visualization of the planes and reducing the invasiveness. The aim of this study was to compare the postoperative complication rate of RNSM to NSM. A systematic search was performed on all (R)NSM articles. The primary outcome was determining the overall postoperative complication rate of traditional NSM and RNSM. Secondary outcomes were comparing the specific postoperative complication rates: implant loss, hematoma, (flap)necrosis, infection, and seroma. Forty-nine studies containing 13,886 cases of (R)NSM were included. No statistically significant differences were found regarding postoperative complications (RNSM 3.9%, NSM 7.0%, p = 0.070), postoperative implant loss (RNSM 4.1%, NSM 3.2%, p = 0.523), hematomas (RNSM 4.3%, NSM 2.0%, p = 0.059), necrosis (RNSM 4.3%, NSM 7.4%, p = 0.230), infection (RNSM 8.3%, NSM 4.0%, p = 0.054) or seromas (RNSM 3.0%, NSM 2.0%, p = 0.421). Overall, there are no statistically significant differences in complication rates between NSM and RNSM.
Highlights
Breast cancer is the most common type of cancer in women and the second most common cause of death due to cancer in women worldwide [1]
The aim of this study is to compare postoperative complications of patients undergoing traditional Nipple-sparing mastectomy (NSM) to Robotic NSM (RNSM) followed by immediate breast reconstruction
One thousand one hundred and sixteen citations were identified by the search and, after removing duplicates, 95 potentially eligible articles were retrieved in full text (Fig. 1)
Summary
Breast cancer is the most common type of cancer in women and the second most common cause of death due to cancer in women worldwide [1]. There are approximately 17,000 new cases of breast cancer in the Netherlands every year. Over 3,000 women of the Dutch population annually die Surgical resection of the primary tumor is the treatment of choice in patients with new-onset breast cancer. Tumor stage and molecular characteristics determine the type of surgery. The ultimate prevention in women with hereditary breast cancer is bilateral prophylactic mastectomy [7]. This means that 20–40% of these patients undergo mastectomies without signs of malignancy. A part of these patients will develop complications or experience poor cosmetic results and carry a significant psychological burden [8, 9]
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