Update on the feasibility and progress on robotic breast surgery Journal Article

Authors: Toesca, A.; Invento, A.; Massari, G.; Girardi, A.; Peradze, N.; Lissidini, G.; Sangalli, C.; Maisonneuve, P.; Manconi, A.; Gottardi, A.; Baker, J. L.; Bottiglieri, L.; Naninato, P.; Farante, G.; Magnoni, F.; De Scalzi, A.; Corso, G.; Colleoni, M.; De Lorenzi, F.; Sacchini, V.; Galimberti, V.; Intra, M.; Rietjens, M.; Veronesi, P.
Article Title: Update on the feasibility and progress on robotic breast surgery
Abstract: Background: Robotic nipple-sparing mastectomy (RNSM) may allow for more precise anatomic dissection and improved cosmetic outcomes over conventional open nipple-sparing mastectomy; however, data regarding the feasibility and safety of the procedure are limited. Objective: The aim of this study was to present and discuss perioperative surgical outcomes and early oncologic follow-up data on consecutive patients undergoing RNSM from June 2014 to January 2019. Methods: Patients underwent RNSM and immediate robotic breast reconstruction through an axillary incision at a single institution. Perioperative data, complications at 3 months postoperatively, pathological data, and adjuvant therapies were recorded. Local recurrence-free, disease-free, and overall survival were analyzed. Results: Overall, 73 women underwent 94 RNSM procedures. Indications were invasive breast cancer in 39 patients, ductal carcinoma in situ in 17 patients, and BRCA mutation in 17 patients. Mean surgery time was 3 h and 32 min. One-step reconstruction with implant occurred in 89.4% of procedures. The rate of complications requiring reoperation was 4.3%, and the rate of flap or nipple necrosis was 1.1%. Median follow-up was 19 months (range 3.1–44.8). No local recurrences occurred. Overall survival at 12, 24, or 60 months was 98% (95% confidence interval 86–100%). Conclusion: We observed a low complication rate in 94 consecutive RNSM procedures, demonstrating the procedure is technically feasible and safe. We found no early local failures at 19 months follow-up. Long-term follow-up is needed to confirm oncologic safety. Future clinical trials to study the advantages and disadvantages of RNSM are warranted. © 2019, Society of Surgical Oncology.
Keywords: adult; human tissue; cancer surgery; gene mutation; major clinical study; overall survival; cancer adjuvant therapy; follow up; prospective study; treatment indication; breast reconstruction; graft necrosis; postoperative complication; feasibility study; operation duration; reoperation; perioperative period; frozen section; incision; tumor invasion; local recurrence free survival; human; female; article; axillary artery; robot assisted surgery; breast carcinoma in situ; local disease free survival; nipple necrosis; robotic nipple sparing mastectomy
Journal Title: Annals of Surgical Oncology
Volume: 26
Issue: 10
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2019-10-01
Start Page: 3046
End Page: 3051
Language: English
DOI: 10.1245/s10434-019-07590-7
PUBMED: 31342391
PROVIDER: scopus
Notes: Article -- Export Date: 1 November 2019 -- Source: Scopus
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