Endoscopy-assisted breast surgery (EABS) performed through minimal axillary and/or peri- areolar incisions is a possible alternative to open surgery for certain patients with breast cancer. In this study, we report the early results of an EABS program in Taiwan.
The medical records of patients who underwent EABS for breast cancer during the period May 2009 to December 2015 were collected from the Taiwan Endoscopic Breast Surgery Cooperative Group database. Data on clinicopathologic characteristics, type of surgery, method of breast reconstruction, complications and recurrence were analyzed to determine the effectiveness and oncologic safety of EABS in Taiwan.
A total of 345 EABS procedures were performed in 320 patients with breast cancer, including 25 (7.2%) patients with bilateral disease. The number of breast cancer patients who underwent EABS increased initially from 2009 to 2012 and then stabilized during the period 2012–2015. The most commonly performed EABS was endoscopy-assisted total mastectomy (EATM) (85.8%) followed by endoscopy-assisted partial mastectomy (EAPM) (14.2%). Approximately 76% of the EATM procedures involved breast reconstruction, with the most common types of reconstruction being implant insertion and autologous pedicled TRAM flap surgery. During the seven-year study period, there was an increasing trend in the performance of EABS for the management of breast cancer when total mastectomy was indicated. The positive surgical margin rate was 1.4 %. Overall, the rate of complications associated with EABS was 13.2 % and all were minor and wound-related. During a median follow-up of 31.7 (4.2–75.6) months, there were 3 (1%) cases of local recurrence, 5 (1.4%) case of distant metastasis and 2 (0.5%) death.
The updated results from the EABS program in Taiwan show that EABS is a safe procedure and results in acceptable cosmetic outcome. These findings could provide an alternative in surgical technique for certain breast cancer patients.
Clinical trial identification
IRB No.: 141224
Legal entity responsible for the study
National Cheng Kung University
Funding from Ministry of Science and Technology, ROC (Nr. 104-2314-B-371 -006 -MY3)
All authors have declared no conflicts of interest.