Complete Endoscopic Subcutaneous Mastectomy and Immediate Reconstruction with Implants for Breast Cancer:Report of 31 Cases / 中国微创外科杂志

ABSTRACT

Objective To explore the surgical skill, safety, and cosmetic outcomes of complete endoscopic subcutaneous mastectomy and immediate reconstruction with implants for breast cancer. Methods From August 2004 to September 2007, 31 women with breast cancer received complete endoscopic subcutaneous mastectomy and immediate reconstruction with implants in our hospital after neoadjuvant chemotherapy. The operation spaces were established by insufflating carbon dioxide after lipolysis and liposuction in the subcutaneous stratum and retromammary space. Subcutaneous mastectomy was carried out under a complete endoscope, sentinel lymph node biopsy or axillary lymph node dissection, and immediate reconstruction with implants were carried out via axillary small incision. Results The operations were completed in all of the 31 cases. Sentinel lymph node biopsy was performed on 15 cases (including supplemental axillary lymph node dissection in 8), and immediate axillary lymph node dissection was done in 16 cases. No cancer infiltration on tumor surface or into the nipple basement was observed in frozen sections during the operation. In one patient, the nipple was partly necrotic. No other complications were found in this series. Three months after the operation, cosmetic results were good in 22 cases (71.0%), average in 7 (22.6%), and poor in 2 (6.4%). The patients were followed for 3 months to 3 years (over 1 year in 15 patients), during which no one had metastasis or recurrence of the tumor. Conclusions Complete endoscopic subcutaneous mastectomy combined with immediate reconstruction with implants is less traumatic and safe with few complications and good cosmetic result. The method is a good choice for patients with early-stage breast cancer.