Single-axillary-incision Endoscopic Nipple/Skin-sparing Mastectomy With Immediate Implant-based Breast Reconstruction of Day Surgery: Preliminary Results, Complications and Patient-reported Outcome From Preliminary 68 Procedures

Abstract Background and Aims The aim of this study is to present a day surgery protocol that minimizes resource utilization to enable hospitals to increase inpatient capacity and maximize treatment efficiency for breast cancer patients undergoing endoscopic nipple/skin-sparing mastectomy(E-N/SSM) with breast reconstruction through a single invisible axillary incision. Methods We retrospectively reviewed 60 consecutive patients(68 breasts) who underwent day surgery of E-N/SSM with implant-based reconstruction from July 2020 to November 2021 in West China Hospital. Postoperative complications, cost-effectiveness, and oncological safety were retrospectively analysed in patients. The SCAR-Q, BREAST-Q reconstruction module and photography were used to evaluate the breast satisfaction and quality of life(QoL). Results Sixty patients(68 breasts)with a mean age of 41.8±9.7 years were examined, with a median follow-up time of 6.5 months. Overall, the major complication rate and minor complication rate was 0% and 10.29%(7/68), respectively. Mean operation time was 123.94±24.26min(Surgeon A) and 180.64±16.68min (Surgeon B and C). The mean score of appearance scale of SCAR-Q was 60.9±12.7 at 3 months after operation. Breast satisfaction scores at 3 and 6 months after operation were significantly better than those before operation and at 1 month after operation (P<0.05); QoL scores (except for Physical Well-being: chest) at 6 months after operation were significantly better than those before operation(P<0.05). No local recurrence or distant metastasis developed. Conclusions Day surgery of E-N/SSM with immediate endoscopic breast reconstruction is safe and feasible in practice.