The Feasibility of Endoscopy-Assisted Breast Conservation Surgery for Patients with Early Breast Cancer

다국어 초록 (Multilingual Abstract)

Purpose: Breast conservation surgery (BCS) has become a standard treatment method for patients with early breast cancer. Endoscopy-assisted BCS (EABCS) can be performed through an inconspicuous periareolar and a small axillary incision for sentinel node biopsy, which may give better cosmetic outcomes than conventional BCS skin incisions. This study was designed to evaluate the feasibility of EABCS for patients with early breast cancer.
Methods: Forty-three patients were candidates for EABCS, and EABCS was performed in 40 patients with breast cancer between January 2008 and July 2010. Their clinicopathological features were retrospectively analyzed. Operative time, margin status,complications, and relapse-free survival were compared with those of patients treated by conventional BCS and who were treated at the same institute during the same period. Results:The most common lesion site of the EABCS and conventional BCS groups was the upper area of the breast. Tumor size in all patients was less than 4 cm (range, 0.4–3.7 cm), and nodal involvement was found in eight (20%) patients in the BCS group. The mean operative time was 110 minutes for the EABCS group and 107 minutes for the conventional BCS group, and those were not significantly different. No significant difference in frozen or final margin status was observed between the EABCS and conventional BCS groups. Relapse-free survival was statistically equivalent between the groups with a median follow-up of 12 months.
Postoperative complications occurred in five cases in four patients with EABCS, which was not significantly different from conventional BCS. Conclusion: Performing EABCS in patients with early breast cancer seems to be feasible and safe. Further study with a longer-term follow-up may be needed to confirm the clinical value of EABCS.

참고문헌 (Reference)

1 Fisher B, "Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer" 347 : 1233-1241, 2002

2 Freedman G, "Patients with early stage invasive cancer with close or positive margins treated with conservative surgery and radiation have an increased risk of breast recurrence that is delayed by adjuvant systemic therapy" 44 : 1005-1015, 1999

3 Ingram D, "Is it time for breast cancer surgeons to embrace endoscopic-assisted mastectomy" 78 : 837-838, 2008

4 Nishimura R, "Investigation of factors related to periods to ipsilateral breast tumor recurrence after breast-conserving surgery and measures for preventing recurrence in early breast cancer" 13 : 152-158, 2006

5 Lee EK, "Endoscopy-assisted breast-conserving surgery for early breast cancer" 30 : 957-964, 2006

6 신혁재, "Endoscopy-assisted Breast Conserving Surgery for Breast Cancer: A Preliminary Clinical Experience" 한국유방암학회 13 (13): 138-146, 2010

7 Yamashita K, "Endoscopic video-assisted breast surgery: procedures and short-term results" 73 : 193-202, 2006

8 Giordano PA, "Endoscopic transaxillary breast augmentation: clinical evaluation of a series of 306 patients over a 9-year period" 27 : 47-54, 2007

9 Troilius C, "Endoscopic transaxillary breast augmentation" 24 : 67-73, 2004

10 Eaves FF 3rd, "Endoscopic techniques in aesthetic breast surgery. Augmentation, mastectomy, biopsy, capsulotomy, capsulorrhaphy, reduction, mastopexy, and reconstructive techniques" 22 : 683-695, 1995

11 Owaki T, "Endoscopic quadrantectomy for breast cancer with sentinel lymph node navigation via a small axillary incision" 14 : 57-60, 2005

12 Keshtgar MR, "Endoscopic mastectomy: what does the future hold" 5 : 107-109, 2009

13 Fukuma E, "Endoscopic breast surgery for breast cancer" 107 : 64-68, 2006

14 Dunne C, "Effect of margin status on local recurrence after breast conservation and radiation therapy for ductal carcinoma in situ" 27 : 1615-1620, 2009

15 Kitamura K, "Early results of an endoscope-assisted subcutaneous mastectomy and reconstruction for breast cancer" 131 (131): S324-S329, 2002

16 Tamaki Y, "Application of endoscopic surgery for breast cancer treatment" 103 : 835-838, 2002