ENDOSCOPIC BREAST SURGERY FOR PERSONALIZATION OF BREAST CANCER TREATMENT yamasita@nms.ac.jp

3103-11

ENDOSCOPIC BREAST SURGERY FOR PERSONALIZATION OF BREAST CANCER TREATMENT

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Japan

Oral or Poster

Breast conserving surgery for early breast cancer is reported to be a good indication of endoscopic breast surgery (EBS), which has been performed on more than 700 patients since 2000. EBS performs all surgical manipulation only through a small axillary skin incision and leaves no wound scar on the breast skin with better aesthetic results. We selected the best suitable treatment to improve the results and postoperative QOL.

Trans-axillary retromammary approach (TARM) is a single port surgery with a small axillary skin incision, 2 to 3 cm long. Detachment behind the mammary gland on the major pectoral muscle fascia under endoscopic view through axillary port. We cut the mammary gland with clear surgical margin. The defect space is sutured by barbed threads, filled with resorbable fiber, or transplant of surrounding tissues, to keep the breast shape. Total mastectomy can be performed with same methods, as extending for whole breast with nipple-sparing. The simultaneous reconstruction can be performed with sillicone expandor or implant.

EBS was performed on 700 patients, breast conserving surgery on 620 patients, and total mastectomy on 80 patients. The operative cost is as low as the conventional one. There was no serious complication after surgery. The original shapes of the breast were preserved well. The operative methods are selected by tumor location and size, patient age and complications, for personalization.

Plastic procedure by endoscopic surgery is necessary to improve the aesthetic results for EBS. The personalized treatment selection bring us good results.