Due to high rate of patient satisfaction and acceptable oncologic safety, nipple-sparing mastectomy (NSM) was increasingly performed in patients with breast cancer without nipple areolar complex (NAC) invasion. Ischemic complications involving the NAC, however, remained an important issue in NSM. In a meta-analysis, around 9.1% of the NSM reported cases were found to have some degree of NAC necrosis, and 2.0% of NSM cases complicated with complete necrosis leading to NAC loss. Novel surgical technique decreasing the risk of NAC ischemia/necrosis remained needed.
Robotic nipple sparing mastectomy (R-NSM), which used surgical platform of da Vinci, could perform NSM and immediate breast reconstruction (IBR) through small and inconspicuous extra-mammary axillary wound. Its application in the management of early breast cancer or risk reducing mastectomy had been reported in some series, and a growing number of R-NSM performed in the world was observed.
To delineate the benefits and limitations of R-NSM versus C-NSM or E-NSM for patients with breast cancer, a case-control comparison study was conducted. The clinical outcome, medical cost, and patient-reported cosmetic results between R-NSM vs C-NSM and E-NSM in a single institution were analyzed and reported.