Endoscopic assisted breast conserving surgery for breast cancer: Clinical outcome, learning curve, and patient reported aesthetic results from preliminary 100 procedures

Background: Endoscopic assisted breast surgery was associated with small and inconspicuous scar and endoscopic assisted breast conserving surgery (E-BCS) for breast cancer was increasingly performed as well. The clinical outcomes, learning curve analysis and patient reported cosmetic result of E-BCS for breast cancer were reported along with a review of the current literature. Methods: A retrospective study analyzing the outcomes of E-BCS for breast cancer patients through an endoscopic breast surgery database in a single institution from June 2009 to May 2019 was performed and a literature review through Pubmed and Medline was conducted as well. Results: 100 consecutive breast cancer patients who underwent E-BCS were analyzed. The mean age of patients was 52.5 years old. Furthermore, the mean pathologic tumor size was 1.6 cm and majority of patients had early stage (13% stage 0, 56% stage I, and 30% stage II) breast cancer. The mean operation time of E-BCS in the current study was 133 +/- 50 min and in learning curve analysis, after accumulation of 15 consecutive cases the operation time significantly decreased. The morbidities of E-BCS were minor and most of them were skin flap related. The margin involvement rate was 4%. About 98% of patients surveyed were satisfied with the incision length, location and scar appearance of E-BCS whereas all of them were satisfied with E-BCS in general. With a mean follow-up of 29.2 +/- 24.4 months, 3% of patients developed locoregional recurrences, 3% had distant metastasis and there were 2 mortalities observed. Conclusion: In our preliminary experience, E-BCS is a promising surgical technique for selected early breast cancer patients with low morbidity, acceptable oncological outcomes and high patient satisfaction. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.