Hung-Wen Lai1,2,3,4,5,6,7,8,9,10, Shou-Tung Chen11,12,13, Chiung-Ying Liao14, Chi Wei Mok15, Ying-Jen Lin16, Dar-Ren Chen11,12,13, Shou-Jen Kuo11,12,13. 1. Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, Changhua, 500, Taiwan. 143809@cch.org.tw. 2. Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan. 143809@cch.org.tw. 3. Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan. 143809@cch.org.tw. 4. Minimal Invasive Surgery Research Center, Changhua Christian Hospital, Changhua, Taiwan. 143809@cch.org.tw. 5. Kaohsiung Medical University, Kaohsiung, Taiwan. 143809@cch.org.tw. 6. Division of Breast Surgery, Yuanlin Christian Hospital, Yuanlin, Taiwan. 143809@cch.org.tw. 7. School of Medicine, National Yang Ming University, Taipei, Taiwan. 143809@cch.org.tw. 8. School of Medicine, Chung Shan Medical University, Taichung, Taiwan. 143809@cch.org.tw. 9. Chang Gung University College of Medicine, Taoyuan City, Taiwan. 143809@cch.org.tw. 10. Division of General Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. 143809@cch.org.tw. 11. Endoscopic and Oncoplastic Breast Surgery Center, Changhua Christian Hospital, 135 Nanxiao Street, Changhua, 500, Taiwan. 12. Division of General Surgery, Changhua Christian Hospital, Changhua, Taiwan. 13. Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua, Taiwan. 14. Department of Radiology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan. 15. Division of Breast Surgery, Department of Surgery, Changi General Hospital, Singapore, Singapore. 16. Tumor Center, Changhua Christian Hospital, Changhua, Taiwan.
Abstract
BACKGROUND: Endoscopy-assisted breast surgery (EABS) performed through minimal axillary and/or peri-areolar incisions is a possible alternative to conventional breast surgery (CBS) for certain patients with breast cancer. In this study, we report the oncologic safety results of EABS compared with CBS. METHODS: Patients underwent EABS for breast cancer during the period June 2010 to March 2020 were collected from the EABS database from single institute, and another cohort of patients, who received CBS, were identified to determine the effectiveness and oncologic safety of EABS. A case-control study was conducted using propensity score matching (PSM) to prevent bias from cases selection. RESULTS: A total of 3426 patients were enrolled in the current study, including 405 patients receiving EABS and 3021 underwent CBS. Before PSM, patients selected for EABS tend to be smaller in tumor size, node negative, early stage, low histologic grade, and HER-2 negative. After PSM, 343 patients underwent EABS were compared with another 343 patients received CBS. The margin involved rate in EABS group is 2.6%, and 5.6% in CBS group (p = 0.054) after PSM. In breast conserving cases, the margin involved rates were 2% in EABS group, and 7.2% in CBS group (p = 0.04). In Kaplan-Meier survival curves analysis, there was no difference in local regional recurrence (p = 0.89), distant metastasis (p = 0.08), and overall survival (p = 0.14). CONCLUSION: The preliminary oncologic safety analysis from current study showed EABS is a safe procedure and results in low margin involved rate, and no increase of locoregional recurrence, distant metastasis or mortality compared with CBS.
BACKGROUND: Endoscopy-assisted breast surgery (EABS) performed through minimal axillary and/or peri-areolar incisions is a possible alternative to conventional breast surgery (CBS) for certain patients with breast cancer. In this study, we report the oncologic safety results of EABS compared with CBS. METHODS:Patients underwent EABS for breast cancer during the period June 2010 to March 2020 were collected from the EABS database from single institute, and another cohort of patients, who received CBS, were identified to determine the effectiveness and oncologic safety of EABS. A case-control study was conducted using propensity score matching (PSM) to prevent bias from cases selection. RESULTS: A total of 3426 patients were enrolled in the current study, including 405 patients receiving EABS and 3021 underwent CBS. Before PSM, patients selected for EABS tend to be smaller in tumor size, node negative, early stage, low histologic grade, and HER-2 negative. After PSM, 343 patients underwent EABS were compared with another 343 patients received CBS. The margin involved rate in EABS group is 2.6%, and 5.6% in CBS group (p = 0.054) after PSM. In breast conserving cases, the margin involved rates were 2% in EABS group, and 7.2% in CBS group (p = 0.04). In Kaplan-Meier survival curves analysis, there was no difference in local regional recurrence (p = 0.89), distant metastasis (p = 0.08), and overall survival (p = 0.14). CONCLUSION: The preliminary oncologic safety analysis from current study showed EABS is a safe procedure and results in low margin involved rate, and no increase of locoregional recurrence, distant metastasis or mortality compared with CBS.
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