Therapeutic nipple-sparing mastectomy combined with endoscopic immediate prosthetic breast reconstruction via axillary incision: a further step towards evidence-based and personalized surgery

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Gianluca Franceschini
Giuseppe Visconti
Giorgia Garganese
Liliana Barone Adesi
Alba Di Leone
Martin Aleandro Sanchez
Lucia Ionta
Marzia Salgarello
Riccardo Masetti

Abstract

INTRODUCTION: Nipple-sparing mastectomy is an oncologically validated technique for selected breast cancer patients and allows to improve aesthetic results and patients quality of life. Conventional skin incisions are often a suboptimal solution due to the visibility of the scars. Aim of this work is to show our innovative technique, which allows to perform nipple‐sparing mastectomy, lymph-node surgery, and endoscopic immediate prosthetic breast reconstruction using a single cosmetic axillary incision.


MATERIALS AND METHODS: Between June 2016 and October 2019, 14 consecutive patients underwent therapeutic nipple‐sparing mastectomy with endoscopic immediate reconstruction via axillary incision; inclusion criteria were cup A or B breasts and tumors less than 3 cm in diameter. Data were recorded in order to evaluate reproducibility, feasibility, safety, aesthetic outcomes and patients quality of life.


RESULTS: Mean age was 46 years old (range: 34‐54 years); median tumor size was 1.7 cm; average follow‐up time was 11 months (range 3-42); median operation time was 340 minutes; mean hospital stay was 4,1 days. Tumor‐free margins were obtained in all 14 cases. No local-regional recurrence occurred during follow‐up. No major complications were experienced. No systemic complications were observed. All patients were satisfied with their aesthetic results, especially the absence of visible scars.


CONCLUSIONS: Therapeutic nipple‐sparing mastectomy with endoscopic immediate prosthetic reconstruction via axillary incision is a safe and appropriate procedure in cup A and B breasts, alternative to conventional techniques. It allows to improve aesthetic outcomes and patients quality of life thanks to a single well-hidden axillary scar.

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How to Cite
Franceschini, Gianluca, et al. “Therapeutic Nipple-Sparing Mastectomy Combined With Endoscopic Immediate Prosthetic Breast Reconstruction via Axillary Incision: A Further Step towards Evidence-Based and Personalized Surgery”. Annali Italiani Di Chirurgia, vol. 91, no. 4, July 2020, pp. 417-25, https://annaliitalianidichirurgia.it/index.php/aic/article/view/2168.
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