Single incision for oncologic breast conserving surgery and sentinel node biopsy in early stage breast cancer: A minimally invasive approach

Breast J. 2019 Jan;25(1):41-46. doi: 10.1111/tbj.13158. Epub 2018 Dec 3.

Abstract

Introduction: Breast conserving surgery (BCS) has a postoperative morbidity up to 30%. We report the feasibility of a single-incision approach for tumor excision and axillary sentinel node biopsy (SNB) sampling intended to minimize patient morbidity and complications.

Materials and methods: A tertiary surgical oncology single surgeon database was retrospectively reviewed for all patients undergoing BCS and SNB between January 2013 and December 2015. The single-incision approach used a single breast incision to resect the tumor and the Lymphazurin-tagged SNB. The multi-incision group used a breast incision and a separate axillary incision.

Results: The single-incision approach was associated with shorter operative time (56 vs 64 minutes, P = 0.026). Sentinel node retrieval was achieved in 100% in both groups. The single-incision technique was used primarily in the upper outer quadrant (N = 41, 85.4%), but was also selectively applied in other quadrants (N = 5). There was no significant difference in complication rates between the two procedures (P = 0.425), and there were no instances of conversion from single-incision to standard BCS-SNB.

Conclusions: Minimally invasive breast conserving surgery is feasible for patients with early breast cancer located in the upper outer quadrants. This technique may reduce postoperative morbidity and improved cosmetic result.

Keywords: breast cancer; breast conserving surgery; minimally invasive breast surgery.

MeSH terms

  • Aged
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery*
  • Female
  • Humans
  • Mastectomy, Segmental / adverse effects
  • Mastectomy, Segmental / methods*
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy / adverse effects
  • Sentinel Lymph Node Biopsy / methods*
  • Surgery, Computer-Assisted / methods
  • Treatment Outcome