Objective: The aim of this prospective study was to assess the feasibility of robotic nipple-sparing mastectomy (RNSM) with immediate prosthetic breast reconstruction (IPBR).
Summary Background Data: RNSM could be a significant advancement in the treatment of breast cancers and prophylaxis because the mastectomy is performed without any scar on the breast.
Methods: RNSM with IPBR was offered to patients with breast cup size A, B or C and ptosis grade ≤ 2. In case of oncologic surgery, RNSM was proposed only if the patient fulfilled oncological indications for NSM, and if the tumor was located more than 2 cm away from the nipple-areola complex. In case of prophylactic surgery, RNSM was proposed only if a high-risk genetic mutation had been identified. The primary endpoint was the conversation rate to open technique. The duration of the surgery, the postoperative complications and the length of the scar were also analyzed.
Results: Of 140 RNSM with IPBR from December 2015 to April 2019, 2 cases of conversion to open technique occurred. Nine infections occurred, three led to implant loss. There were one NAC necrosis. No other major complications were observed. The duration of the whole procedure was reduced from 214 min to 85 min. The length of the scar was between 2.5 and 5 cm.
Conclusion: Preliminary data attest to the feasibility, the reproducibility and the safety of this approach. However, long-term data are needed to confirm the oncological safety and the aesthetic stability of the result.