演題

Long-term results over 10 years after video-assisted breast surgery are evaluated for early breast cancer.

[演者] 山下 浩二:1
[著者] 柳原 恵子:1, 武井 寛幸:1
1:日本医科大学乳腺科

Background: The conventional breast surgery, including breast conserving surgery (BCS), makes many long wound scars on the breast with granulated ugly scars. We devised endoscopic video-assisted breast surgery (VABS) to perform partial and total mastectomy without any wound on the breast. We have performed on more than 400 patients since 2001. We evaluated the long term results of the aesthetics and curability over 10 years after surgery.Methods: VABS consists of BCS, mastectomy, sentinel node (SN) biopsy, axillary node dissection, and breast reconstructions. It uses periareolar approach and/or axillary approach. Trans-axillary retromammary approach (TARM) is a single port surgery with an axillary skin incision. The each wound length is usually 2.5cm, but 1cm for SN biopsy. We cut the mammary gland with clear surgical margin from behind the mammary gland. The postoperative aesthetic results were evaluated by ABNSW.Result: BCS was performed on 300 patients and skin-sparing mastectomy on 50 patients. The operative cost is very low as the conventional one. There was no significant difference in operational infestation. There was no serious complication after surgery. Surgical margin was minimally positive in 2 patients. The original shapes of the breast were preserved well. The follow-up is 160 months at maximum. There is 3 locoregional recurrences and 14 distant metastases. 5-year survival rate is 97.5%. The postoperative esthetic results were excellent and better. The sensory disturbance was minimal. All patients expressed great satisfaction.Conclusions: VABS can be considered as a good surgical procedure concerning locoregional control and esthetics.
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