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Endoscopic mastectomy followed by immediate breast reconstruction with fat grafting for breast cancer

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Abstract

Background

Although endoscopic mastectomy has been associated with good tolerance and enhanced patient satisfaction, limitations such as the implant or flap size for reconstruction with small incisions remain unresolved. Fat grafting (FG) can expand tissue volume with pinhole skin incisions. Herein, we evaluated the safety and efficacy of endoscopic mastectomy followed by immediate FG.

Methods

Patients who underwent endoscopic mastectomy with immediate FG reconstruction from 2015 to 2021 were retrospectively evaluated to establish surgical outcomes and prognosis.

Results

Twenty-three patients with clinical stage 0 or I breast cancer underwent unilateral endoscopic mastectomy with immediate FG. The median age was 45 years (41–55), and the median body mass index was 19.3 kg/m2 (15.8–26.6). Endoscopically performed procedures included skin-sparing mastectomies in 18 patients (78%) and nipple-sparing mastectomies in five patients (22%). The median procedure duration was 295 min (242–346). The median specimen weight was 133 g (71–334), and the median grafted fat volume was 200 mL (136–320). No patient required reoperation or additional procedures for complications. One patient experienced recurrence at a median follow-up of 56.1 months and underwent resection; the patient was alive without recurrence 54 months post-resection.

Conclusion

To the best of our knowledge, this is the first report of endoscopic mastectomy with immediate FG for reconstruction. When compared with other immediate autologous reconstructions, our strategy could minimize the skin incision and procedure duration, as well as limit complications. Further prospective investigations are needed to evaluate oncological safety, surgical outcomes, and patient satisfaction.

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Data availability

The data underlying this study were collected and analyzed at the Department of Breast and Thyroid Surgery, Yokohama City University Medical Center. Data will be shared on request to the corresponding author.

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Acknowledgements

The authors thank Dr. Eisuke Fukuma for inviting us to the Kameda Medical Center for observation and guidance during the endoscopic mastectomy. The authors thank Editage (www.editage.com) for English language editing.

Funding

This study was supported by JSPS KAKENHI (Grant number: JP22K16449). The funding source had no involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafune-Cho, Minami-Ku, Yokohama, Kanagawa, 232-0024, Japan

    Kazutaka Narui, Kei Kawashima, Yoshie Fujiwara, Shoko Adachi, Chiho Suzuki, Tomoko Wada & Shinya Yamamoto

  2. Department of Plastic, Reconstructive and Aesthetic Surgery, Toyama University Hospital, Toyama, Toyama, Japan

    Toshihiko Satake

  3. Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo, Tokyo, Japan

    Takashi Ishikawa & Natsuki Uenaka

  4. Department of Plastic Surgery, Yokohama City University Medical Center, Yokohama, Japan

    Mayu Muto & Yui Tsunoda

  5. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

    Akimitsu Yamada, Masanori Oshi & Itaru Endo

  6. Department of Pathology, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan

    Mikiko Tanabe

  7. Department of Plastic and Reconstructive Surgery, Yokohama City University Hospital, Yokohama, Kanagawa, Japan

    Jiro Maegawa

Authors
  1. Kazutaka Narui
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  2. Toshihiko Satake
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  3. Takashi Ishikawa
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Corresponding author

Correspondence to Kazutaka Narui.

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Conflict of interest

The authors declare that they have no potential conflicts of interest.

Ethical standards

Experiments performed comply with the current laws in Japan, and written informed consent was obtained from patients.

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Cite this article

Narui, K., Satake, T., Ishikawa, T. et al. Endoscopic mastectomy followed by immediate breast reconstruction with fat grafting for breast cancer. Breast Cancer 31, 476–484 (2024). https://doi.org/10.1007/s12282-024-01561-x

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  • DOI: https://doi.org/10.1007/s12282-024-01561-x

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