Clinical effect evaluation of endoscopic radical mastectomy versus open surgery:a retrospective study
Objective To evaluate the safety and oncologic efficacy for endoscopic subcutaneous mastectomy in patients with early stage breast cancer.Methods A total of 98 patients who underwent en-doscopic mastectomy or open mastectomy from January 2021 to December 2023 were included in this study.The patients were grouped according to the type of operation(46 in the endoscopic group and 46 in the open group).Both groups were treated with nipple-preserving and areola-preserving modified radical mastecto-my.The short-and long-term outcome was compared between the two groups.All the patients were fol-lowed up until death or last follow-up in June 30,2023.Measurement data were analyzed using Student's t-test and counting data using chi-square test.Cumulative survival was compared using Kaplan-Meier curve and Log-rank test,and prognostic related risk factors were analyzed using Cox regression model.Results There were no statistically significant differences in age,menstrual status,tumor location,tumor length,clinical staging,and number of sentinel lymph nodes between endoscopic group and open group(t=0.045,0.989,0.990,0.366,x2=0.667,0.383,P＞0.05).The operation time[(90.6±10.0)min vs.(65.9±11.1)min],average bleeding volume[(39.9±8.2)ml vs.(56.5±12.7)ml],drainage volume[(854.4±132.2)ml vs.(1 709.9±278.8)ml],length of incision[(8.6±1.2)cm vs.(21.0±3.8)cm],and duration of hospital stay[(6.1±0.9)d vs.(6.7±1.0)d]were reduced in pa-tients receiving endoscopic subcutaneous mastectomy,and the postoperative quality of life and postoperative satisfactory rate were significantly superior to the open group;but operation time in the endoscopic group[(93.9％)vs.(75.5％)]was longer than that of the open group(t=11.573,7.687,19.408,3.346,3.122,P＜0.05).There were no significant differences in the incidence of postoperative complications be-tween the two groups(x2=0.445,P＞0.05).No significant difference was found in the 3-year OS and PFS rates between the two groups(x2=0.344,0.544,P＞0.05).Univariate Cox regression showed that age,BMI,menstrual status,sentinel lymph node number,molecular typing,T stage and surgical proce-dure were not independent prognostic factors.Conclusion Endoscopic subcutaneous mastectomy is supe-rior to open surgery in terms of intraoperative bleeding,postoperative drainage,incision size for early stage breast cancer,and could also attain a stable oncologic outcome for breast cancer.
Breast cancerEndoscopicNipple-preserving and areola-preserving modified rad-ical mastectomyPrognosis
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