Endoscopic breast surgery for breast cancer: Restore confidence without cosmetic concerns

Breast cancer is one of the most common cancers found in women worldwide. Breast cancer treatment options are individually selected based on type of breast cancer, stage, grade, size and whether the cancer cells are sensitive to hormones. Overall health status and each patient’s preference are also taken into consideration. Breast cancer surgery remains the primary treatment option to prevent cancer metastasis (spreading to other organs in the body) and enhance survival rates, resulting in improved chance of being cured.   Most women undergo surgery for breast cancer and they may also receive additional treatment after surgery, such as chemotherapy, hormone therapy or radiation. Chemotherapy might also be used before surgery in certain situations. There are several breast surgery approaches. The selected surgical technique is determined by breast cancer stage and type. Besides the concerns over disease and its prognosis, patients are often worried about the wounds and surgical scars that significantly impair their confidence. More importantly, after some breast tissues or whole breasts are removed, a number of patients become anxious since the sizes of their breasts alter, compared to the previous sizes prior to surgery. Endoscopic breast surgery is a minimally invasive surgical procedure using an endoscope, a thin fiber-optic instrument with camera and lens attached to it. Instead of a large incision, endoscopic breast surgery is performed through smaller incisions, resulting in less pain, shorter hospital stay, less postoperative complications and faster recovery. The superior benefit also includes the hidden surgical scars that cannot be visibly seen. Moreover, breast augmentation can be concurrently conducted at the same time after endoscopic breast surgery is completely done, allowing patient’s confidence to be fully restored.

Regarding the clinical study published in Nature (2017), it aims to evaluate the differences in terms of postoperative outcomes and cosmetic satisfaction between endoscopic nipple sparing mastectomy (surgery to remove the whole breast) with immediate implant-based reconstruction and breast conserving surgery applied to early-stage breast cancer. In accordance with cosmetic outcomes, patients who underwent endoscopic surgery with immediate implant-based reconstruction are more likely to get a satisfactory postoperative breast appearance without increasing postoperative complications. Since this surgical approach enhances the appearance of breasts without additional operative risks and side effects, it represents an alternative treatment for early-stage breast cancer patients.

 

Get to know endoscopic breast surgery

Endoscopic breast surgery is a minimally invasive surgical procedure to remove breast cancer through small axillary and/or periareolar incisions.  During the procedure, breast surgeon makes small incisions and inserts surgical instruments through surgical plane. These include retractor and an endoscope –a thin fiber-optic instrument attached with camera and lens. The camera displays the images of breast tissues and adjacent areas onto a large screen and guides breast surgeon during the procedure. Due to an ultra high resolution, it allows breast surgeon to precisely remove cancerous tissues and other part as necessary, leading to less operative time.  Immediate breast reconstruction surgery can be subsequently performed right away after endoscopic breast surgery. There are two main techniques for reconstructing the breast: implant reconstruction using implant that is filled with saline (salt water) or silicone gel and autologous or flap reconstruction using patient’s tissue transplanted from another part of the body, such as belly, thigh or back. However, if breast reconstruction is required, additional advices are made by breast surgeon prior to surgery. Not only increase the chance of being cured from breast cancer, but endoscopic breast surgery also enhances cosmetic outcomes and improves patients’ confidence and satisfaction. Nevertheless, to achieve the best possible treatment outcome, this surgical approach largely requires the profound expertise and experience of breast surgeon.

 

Stage of breast cancer and endoscopic breast surgery

The stage of breast cancer ranges from 0-4. Stage 0 is the earliest detection of breast cancer development. There is no invasion to the breast tissue. Discovered at this stage, breast cancer can be cured. Stage 1 is defined as cancer measuring less than 2 cm. confined in a limited area which has not spread to the lymph nodes. Stage 2 is cancer sized between 2-5 cm. and it begins to spread into the lymph nodes in the armpit. At this stage, there is no lymph node invasion to other areas. Stage 3 refers to breast cancer sized over 5 cm. which invades the lymph nodes in the armpit but not to other organs. Stage 4 is breast cancer that spreads to other parts of the body, regardless of its size.

Endoscopic breast surgery can be an effective option to treat stage 0 to 3 breast cancer (in some circumstances). However, endoscopic nipple sparing breast surgery is not recommended in patients with stage 4 breast cancer in which cancer has already spread to other organs including skin, nipple or areolar. This approach is not applicable for patients with Paget’s disease of the breast, which is a rare condition associated with breast cancer.

 

Benefits of endoscopic breast surgery

Patients undergoing endoscopic breast surgery experience a number of advantages, including:

  • Hidden surgical scars with superior cosmetic outcomes and satisfaction
  • Smaller incisions and less damages to surrounding areas
  • Less pain
  • Accurate and effective technique to remove breast cancer while preserving surrounding tissue
  • Shortened operative time
  • Both surgical treatment of breast cancer and breast reconstruction surgery can be concurrently performed at the same time.
  • Improved post-operative care due to smaller incisions
  • Enhanced self-confidence

An increasingly important issue in breast cancer treatment is to improve patient’s quality of life, especially in women who are extremely concerned about cosmetic outcomes and their breast appearances after breast surgery. Endoscopic breast surgery serves as an effective treatment option that does not only result in greater chances of being cured, but this approach also significantly enhances confidence and femininity to the patients.

 

 

Reference:
Asst. Prof. Dr. Sasithorn Sujarittanakarn
Brest surgeon, Breast Center, Bangkok Cancer Hospital Wattanosoth


For more information, please contact
Breast Center, Bangkok Cancer Hospital Wattanosoth
Tel:  +662 310 3016 or +662 755 1024