311P - Long-term results of the endoscopic video-assisted breast surgery over 10 years evaluated for early breast cancer

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Breast Cancer, Early Stage
Imaging, Diagnosis and Staging
Surgery and/or Radiotherapy of Cancer
Presenter Koji Yamashita
Citation Annals of Oncology (2014) 25 (suppl_4): iv85-iv109. 10.1093/annonc/mdu327
Authors K. Yamashita, H. Takei
  • Department Of Breast Surgery, Nippon Medical School Main Hospital, 113-8603 - Tokyo/JP

Abstract

Aim

Breast-conserving surgery (BCS) has been proven to be a standard treatment for early breast cancer. However, conventional surgery makes many long wound scars on the breast. They often make granulated ugly scars. We devised the endoscopic breast surgery to perform partial and total mastectomy without any wound on the breast. We named ithis video-assisted breast surgery (VABS). We have performed it on 350 patients since 2001. In this study, we evaluated the long-term results of the aesthetics and curability over 10 years after surgery.

Methods

VABS consists of BCS, mastectomy, sentinel node (SN) biopsy, axillary node dissection, and breast reconstructions. It uses periareolar approach and/or axillary approach. Trans-axillary retromammary approach (TARM) is a single port surgery with an axillary skin incision. Each wound length is usually 2.5cm, but 1 cm for SN biopsy. This surgery is applied for early breast cancer, stage I and II. We dissected major pectoral muscle fascia to detach retromammary tissue. We cut the mammary gland with clear surgical margin. The breast reconstruction was made by filling absorbable oxydized cellulose for BCS and by silicon implant for skin-sparing mastectomy. The postoperative aesthetic results were evaluated by ABNSW.

Results

BCS was performed on 300 patients and skin-sparing mastectomy on 50 patients. The operative cost is very low compared with conventional surgery. There was no significant difference in surgical invasion between VABS and conventional surgery. There was no serious complication after surgery. Surgical margin was minimally positive in 2 patients. The original shapes of the breast were preserved well. All patients expressed great satisfaction. The follow-up is 158 months at maximum. There are 3 locoregional recurrences and 14 distant metastases. 5-year survival rate is 97.5%. With regard to TARM, The skin incision only in the axilla made for better look and shape of the breast. The postoperative aesthetic results were excellent. The sensory disturbance was minimal. All patients expressed great satisfaction.

Conclusions

VABS can be considered as a good surgical procedure concerning locoregional control and aesthetics. TARM is better in patients without tumor nipple extension.

Disclosure

All authors have declared no conflicts of interest.