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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2018

01-09-2018 | Breast Oncology

Robotic Prophylactic Nipple-Sparing Mastectomy with Immediate Prosthetic Breast Reconstruction: A Prospective Study

Authors: Benjamin Sarfati, MD, Samuel Struk, MD, Nicolas Leymarie, MD, Jean-François Honart, MD, Heba Alkhashnam, MD, Kim Tran de Fremicourt, MD, Angelica Conversano, MD, Françoise Rimareix, MD, Marie Simon, MD, Stefan Michiels, MD, Frédéric Kolb, MD

Published in: Annals of Surgical Oncology | Issue 9/2018

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Abstract

Background

Robotic nipple-sparing mastectomy (RNSM) could be a significant advancement in the treatment of breast cancers and prophylaxis because the mastectomy is performed without leaving any scar on the breast. The aim of this study was to assess the feasibility and the safety of RNSM with immediate prosthetic breast reconstruction (IPBR).

Methods

In this prospective study, RNSM with IPBR was offered to patients with breast cup size A, B or C and ptosis grade ≤ 2. In case of oncologic surgery, RNSM was proposed only if the tumor was located more than 2 cm away from the nipple-areola complex (NAC) and if postoperative radiation was not indicated. In case of prophylactic surgery, RNSM was proposed only if a high-risk genetic mutation had been identified. The primary endpoint was the rate of skin or NAC necrosis. The rate of conversion to open technique, the duration of the procedure, and postoperative complications were also analyzed.

Results

Sixty-three RNSM with IPBR were performed in 33 patients. There were no cases of mastectomy skin flap or NAC necrosis. We had to convert to an open technique in one case (1.6%). Three infections occurred (4.8%), one leading to implant loss (1.6%). No other major complications were observed.

Conclusions

Preliminary data attest to the feasibility, the reproducibility, and the safety of this approach. However, long-term data are needed to confirm the oncological safety and the esthetic stability of the result.
Trial registration identifier NCT02673268.
Appendix
Available only for authorised users
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Metadata
Title
Robotic Prophylactic Nipple-Sparing Mastectomy with Immediate Prosthetic Breast Reconstruction: A Prospective Study
Authors
Benjamin Sarfati, MD
Samuel Struk, MD
Nicolas Leymarie, MD
Jean-François Honart, MD
Heba Alkhashnam, MD
Kim Tran de Fremicourt, MD
Angelica Conversano, MD
Françoise Rimareix, MD
Marie Simon, MD
Stefan Michiels, MD
Frédéric Kolb, MD
Publication date
01-09-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 9/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6555-x

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