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Surgical and Oncologic Outcomes of Robotic and Conventional Nipple-Sparing Mastectomy with Immediate Reconstruction: International Multicenter Pooled Data Analysis

Authors
 Hyung Seok Park  ;  Jeea Lee  ;  Hung-Wen Lai  ;  Jung Mi Park  ;  Jai Min Ryu  ;  Jeong Eon Lee  ;  Jee Ye Kim  ;  Emilia Marrazzo  ;  Alessandra Margherita De Scalzi  ;  Giovanni Corso  ;  Filippo Montemurro  ;  Guglielmo Gazzetta  ;  Giada Pozzi  ;  Antonio Toesca 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.29(11) : 6646-6657, 2022-10 
Journal Title
ANNALS OF SURGICAL ONCOLOGY
ISSN
 1068-9265 
Issue Date
2022-10
Abstract
Background: Robotic nipple-sparing mastectomy (RNSM) has been developed to reduce conspicuous scar and increase the quality of life in women. This study aimed to evaluate the surgical and oncologic outcomes of RNSM with immediate breast reconstruction (IBR) compared with conventional nipple-sparing mastectomy (CNSM).

Patients and methods: This international multicenter, pooled analysis of individual patient-level data enrolled a total of 755 procedures in 659 women (609 had breast cancer and 50 underwent risk-reducing mastectomy) who underwent nipple-sparing mastectomy with IBR. Surgical and oncologic outcomes, including 30-days postoperative (POD 30d) complication rate, nipple necrosis rate, grade of Clavien-Dindo classification, disease-free survival, and overall survival, were evaluated. Propensity score-matched analyses were performed to adjust for confounding factors.

Results: The median age of both the RNSM and CNSM groups was 45 years. The RNSM group had lower body mass index (BMI) and a higher proportion of benign disease compared with the CNSM group. POD 30d complications and postoperative complication grade III rates were lower in the RNSM group than in the CNSM group (p < 0.05). The nipple necrosis rate was 2.2% and 7.8% for RNSM and CNSM, respectively (p = 0.002). After propensity score matching, significantly lower rates of POD 30d complications, nipple necrosis, and postoperative complication grade III occurred in the RNSM group than in the CNSM group (all p < 0.05). Oncologic outcomes were not significantly different between the two groups.

Conclusion: RNSM can provide better cosmetic results with favorable surgical and oncologic outcomes for women with early breast cancer or BRCA mutation.
Full Text
https://link.springer.com/article/10.1245/s10434-022-11865-x
DOI
10.1245/s10434-022-11865-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jee Ye(김지예) ORCID logo https://orcid.org/0000-0003-3936-4410
Park, Hyung Seok(박형석) ORCID logo https://orcid.org/0000-0001-5322-6036
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/192159
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