Endoscopy-assisted Breast Conserving Surgery of Breast Cancer

Pae, Won Kil; Park, Yong Lai; Lee, Eun Kyu

Abstract

PURPOSE
Breast conserving surgery is now accepted as one of the standard therapeutic options for stage I and II breast cancers. Although breast conserving surgery can retain a good breast shape, a long marked operation scar would be a disadvantage. To improve the cosmetic outcome of the breast, endoscopy-assisted breast conserving surgery which can be performed through minimal axillary and periareolar semicircular incisions, was undertaken. METHODS: Between October 2002 and May 2003, 19 breast cancer patients whose tumor sizes were less than 3 cm and clinically node negative without invasion to the skin and pectoralis major underwent endoscopy-assisted breast conserving surgery. Firstly, an endoscopic dye-guided sentinel node biopsy was performed through a low transverse axillary incision laterally to the pectoralis major. A subpectoral pocket was gently created by Vein Harvest under the view of endoscopic monitor. A periareolar semicircular incision was made to create the skin flap and the tumor-containing quadrant resected with a Visiport and PowerStar Scissors. Frozen section biopsies were carried out to rule out tumor invasion to the resection margin. The patients and tumor characteristics, operation time and amounts of bleedings were evaluated. RESULTS: The mean age of patients was 45 years (35~64). The mean tumor size was 2.2 cm (0.2~5.0 cm). The average operation time of the initial 8 cases, with the exception of the 3 that underwent axillary node dissection was 168 minute, and that of latter 8 was 138 minute (P<0.001). The mean amounts of operative bleeding were 184 ml. There were no major complications. CONCLUSION: Endoscopy-assisted breast conserving surgery is a new technique that can minimize the long operation scar obtained with classic breast conserving surgery. In properly selected cases, our results shows maximized cosmetic satisfaction of breast cancer patients, with a shortened operation time after the learning period, and shows promise as an alternative to the classic breast conserving surgery.