An innovative exploration of endoscopic nipple-sparing mastectomy combined with immediate pre-pectoral implant-based breast reconstruction with TiLoop Bra via single axillary incision for breast cancer patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

QIN Xiangquan ¹ , WANG Tiantian ¹ , XIE Yanyan ¹ , LIANG Faqing ¹ , FENG Yu ¹ , ZHOU Jiao ¹ , HUANG Yixuan ¹ , LI Juan ¹ , QIU Mengxue ¹ , ZHANG Songbo ¹ , WEN Nan ¹ , ZHOU Yuting ¹ , YANG Huanzuo ¹ ,  LV Qing ^1,2 ,  DU Zhenggui ^1,2

1. Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. Center for Breast Disease Treatment, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

LV Qing, Email: lqlq1963@163.com; DU Zhenggui, Email: docduzg@163.com

Keywords：

Breast cancer; endoscopy; breast reconstruction; reverse sequence method; traction line mesh method

DOI：

10.7507/1007-4848.202106048

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the surgical technique and preliminary results of endoscopic nipple-sparing mastectomy (E-NSM) and immediate pre-pectoral implant-based breast reconstruction (BR) with titanium-coated polypropylene mesh (TiLoop Bra) via single axillary incision for breast cancer patients.Methods The clinical data of 9 consecutive female patients who underwent E-NSM and immediate pre-pectoral implant-based BR with TiLoop Bra from March to May 2021 were retrospectively analyzed. The mean age of patients was 40.6 (22-60) years. The operation time, early complications were collected, and the patients' social and mental health, breast satisfaction and chest function before and after the operation were assessed with the BREAST-Q questionnaire.Results All the patients had unicentric tumor with a mean diameter of 2.4 (0.6-4.7) cm. The mean distance from the tumor to the nipple was 2.5 (2-4) cm. There were 2 patients with tumor stage 0 and 7 patients with stageⅠ. The mean operation time was 161.1 (125-201) min, the mean blood loss was 41.1 mL and the hospital stay time was 1.5 d. There were 5 patients in the day-care unit. All the patients were successfully followed up with a median follow-up time of 1 (1-2) month. One (11.1%) patient with depigmentation of the nipple-areola complex caused by mild ischemia. None of the patients had incision complications, subcutaneous emphysema, hematoma, infection, nipple-areola or skin flaps necrosis, implant loss. During the follow-up period, no local/regional recurrence or distant metastasis was found. Chest well-being was decreased in the first month after the surgery compared with preoperative status, and the difference was statistically significant (P=0.001). There was no statistical difference in the breast satisfaction or psychosocial function scores between pre- and post-operation (P>0.05).Conclusion E-NSM and immediate pre-pectoral implant-based BR with TiLoop Bra via single axillary incision has minimal trauma, rapid postoperative recovery, short operation time, few early complications and good early cosmetic effect, and the short-term result is satisfactory.

Citation： QIN Xiangquan, WANG Tiantian, XIE Yanyan, LIANG Faqing, FENG Yu, ZHOU Jiao, HUANG Yixuan, LI Juan, QIU Mengxue, ZHANG Songbo, WEN Nan, ZHOU Yuting, YANG Huanzuo, LV Qing, DU Zhenggui. An innovative exploration of endoscopic nipple-sparing mastectomy combined with immediate pre-pectoral implant-based breast reconstruction with TiLoop Bra via single axillary incision for breast cancer patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(9): 1029-1036. doi: 10.7507/1007-4848.202106048 Copy

1.	Akram M, Iqbal M, Daniyal M, et al. Awareness and current knowledge of breast cancer. Biol Res, 2017, 50(1): 33.
2.	The Lancet. GLOBOCAN 2018: Counting the toll of cancer. Lancet, 2018, 392(10152): 985.
3.	Ward EM, DeSantis CE, Lin CC, et al. Cancer statistics: Breast cancer in situ. CA Cancer J Clin, 2015, 65(6): 481-495.
4.	Tolia M, Zygogianni A, Kouvaris JR, et al. The key role of bisphosphonates in the supportive care of cancer patients. Anticancer Res, 2014, 34(1): 23-37.
5.	Dean C, Chetty U, Forrest AP. Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy. Lancet, 1983, 1(8322): 459-462.
6.	Santosa KB, Qi J, Kim HM, et al. Long-term patient-reported outcomes in postmastectomy breast reconstruction. JAMA Surg, 2018, 153(10): 891-899.
7.	Snyderman RK, Guthrie RH. Reconstruction of the female breast following radical mastectomy. Plast Reconstr Surg, 1971, 47(6): 565-567.
8.	Triadafilopoulos G. Endoscopic options for gastroesophageal reflux: Where are we now and what does the future hold? Curr Gastroenterol Rep, 2016, 18(9): 47.
9.	Yamashita K, Shimizu K. Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic lymphography. Surg Endosc, 2008, 22(2): 392-397.
10.	Hong Y, Shin H. Early results of an endoscopy-assisted nipple-sparing mastectomy for early breast cancer. Eur J Cancer, 2012, 48(3): S196-S197.
11.	Angarita FA, Castelo M, Englesakis M, et al. Robot-assisted nipple-sparing mastectomy: Systematic review. Br J Surg, 2020, 107(12): 1580-1594.
12.	Fracol M, Feld LN, Chiu WK, et al. An overview of animation deformity in prosthetic breast reconstruction. Gland Surg, 2019, 8(1): 95-101.
13.	Cattelani L, Polotto S, Arcuri MF, et al. One-step prepectoral breast reconstruction with dermal matrix-covered implant compared to submuscular implantation: Functional and cost evaluation. Clin Breast Cancer, 2018, 18(4): e703-e711.
14.	Sobti N, Weitzman RE, Nealon KP, et al. Evaluation of capsular contracture following immediate prepectoral versus subpectoral direct-to-implant breast reconstruction. Sci Rep, 2020, 10(1): 1137.
15.	Sinnott CJ, Persing SM, Pronovost M, et al. Impact of postmastectomy radiation therapy in prepectoral versus subpectoral implant-based breast reconstruction. Ann Surg Oncol, 2018, 25(10): 2899-2908.
16.	Toesca A, Manconi A, Peradze N, et al. Preliminary report of robotic nipple-sparing mastectomy and immediate breast reconstruction with implant. Eur J Cancer, 2015, 51(2): S309.
17.	Caplin DA. Indications for the use of MemoryShape breast implants in aesthetic and reconstructive breast surgery: Long-term clinical outcomes of shaped versus round silicone breast implants. Plast Reconstr Surg, 2014, 134(3 Suppl): 27S-37S.
18.	Daar DA, Abdou SA, Rosario L, et al. Is there a preferred incision location for nipple-sparing mastectomy? A systematic review and meta-analysis. Plast Reconstr Surg, 2019, 143(5): 906e-919e.
19.	Alani HA, Balalaa N. Complete tissue expander coverage by musculo-fascial flaps in immediate breast mound reconstruction after mastectomy. J Plast Surg Hand Surg, 2013, 47(5): 399-404.
20.	Gschwantler-Kaulich D, Schrenk P, Bjelic-Radisic V, et al. Mesh versus acellular dermal matrix in immediate implant-based breast reconstruction—A prospective randomized trial. Eur J Surg Oncol, 2016, 42(5): 665-671.
21.	Dieterich M, Faridi A. Biological matrices and synthetic meshes used in implant-based breast reconstruction—A review of products available in Germany. Geburtshilfe Frauenheilkd, 2013, 73(11): 1100-1106.
22.	Logan Ellis H, Asaolu O, Nebo V, et al. Biological and synthetic mesh use in breast reconstructive surgery: A literature review. World J Surg Oncol, 2016, 14: 121.

1. Akram M, Iqbal M, Daniyal M, et al. Awareness and current knowledge of breast cancer. Biol Res, 2017, 50(1): 33.
2. The Lancet. GLOBOCAN 2018: Counting the toll of cancer. Lancet, 2018, 392(10152): 985.
3. Ward EM, DeSantis CE, Lin CC, et al. Cancer statistics: Breast cancer in situ. CA Cancer J Clin, 2015, 65(6): 481-495.
4. Tolia M, Zygogianni A, Kouvaris JR, et al. The key role of bisphosphonates in the supportive care of cancer patients. Anticancer Res, 2014, 34(1): 23-37.
5. Dean C, Chetty U, Forrest AP. Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy. Lancet, 1983, 1(8322): 459-462.
6. Santosa KB, Qi J, Kim HM, et al. Long-term patient-reported outcomes in postmastectomy breast reconstruction. JAMA Surg, 2018, 153(10): 891-899.
7. Snyderman RK, Guthrie RH. Reconstruction of the female breast following radical mastectomy. Plast Reconstr Surg, 1971, 47(6): 565-567.
8. Triadafilopoulos G. Endoscopic options for gastroesophageal reflux: Where are we now and what does the future hold? Curr Gastroenterol Rep, 2016, 18(9): 47.
9. Yamashita K, Shimizu K. Video-assisted breast surgery and sentinel lymph node biopsy guided by three-dimensional computed tomographic lymphography. Surg Endosc, 2008, 22(2): 392-397.
10. Hong Y, Shin H. Early results of an endoscopy-assisted nipple-sparing mastectomy for early breast cancer. Eur J Cancer, 2012, 48(3): S196-S197.
11. Angarita FA, Castelo M, Englesakis M, et al. Robot-assisted nipple-sparing mastectomy: Systematic review. Br J Surg, 2020, 107(12): 1580-1594.
12. Fracol M, Feld LN, Chiu WK, et al. An overview of animation deformity in prosthetic breast reconstruction. Gland Surg, 2019, 8(1): 95-101.
13. Cattelani L, Polotto S, Arcuri MF, et al. One-step prepectoral breast reconstruction with dermal matrix-covered implant compared to submuscular implantation: Functional and cost evaluation. Clin Breast Cancer, 2018, 18(4): e703-e711.
14. Sobti N, Weitzman RE, Nealon KP, et al. Evaluation of capsular contracture following immediate prepectoral versus subpectoral direct-to-implant breast reconstruction. Sci Rep, 2020, 10(1): 1137.
15. Sinnott CJ, Persing SM, Pronovost M, et al. Impact of postmastectomy radiation therapy in prepectoral versus subpectoral implant-based breast reconstruction. Ann Surg Oncol, 2018, 25(10): 2899-2908.
16. Toesca A, Manconi A, Peradze N, et al. Preliminary report of robotic nipple-sparing mastectomy and immediate breast reconstruction with implant. Eur J Cancer, 2015, 51(2): S309.
17. Caplin DA. Indications for the use of MemoryShape breast implants in aesthetic and reconstructive breast surgery: Long-term clinical outcomes of shaped versus round silicone breast implants. Plast Reconstr Surg, 2014, 134(3 Suppl): 27S-37S.
18. Daar DA, Abdou SA, Rosario L, et al. Is there a preferred incision location for nipple-sparing mastectomy? A systematic review and meta-analysis. Plast Reconstr Surg, 2019, 143(5): 906e-919e.
19. Alani HA, Balalaa N. Complete tissue expander coverage by musculo-fascial flaps in immediate breast mound reconstruction after mastectomy. J Plast Surg Hand Surg, 2013, 47(5): 399-404.
20. Gschwantler-Kaulich D, Schrenk P, Bjelic-Radisic V, et al. Mesh versus acellular dermal matrix in immediate implant-based breast reconstruction—A prospective randomized trial. Eur J Surg Oncol, 2016, 42(5): 665-671.
21. Dieterich M, Faridi A. Biological matrices and synthetic meshes used in implant-based breast reconstruction—A review of products available in Germany. Geburtshilfe Frauenheilkd, 2013, 73(11): 1100-1106.
22. Logan Ellis H, Asaolu O, Nebo V, et al. Biological and synthetic mesh use in breast reconstructive surgery: A literature review. World J Surg Oncol, 2016, 14: 121.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

An innovative exploration of endoscopic nipple-sparing mastectomy combined with immediate pre-pectoral implant-based breast reconstruction with TiLoop Bra via single axillary incision for breast cancer patients

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content