Single-Port Insufflation Endoscopic Nipple-Sparing Mastectomy in Early Breast Cancer: A Retrospective Cohort Study

Abstract Purpose To compare the oncologic safety, aesthetic outcome, and upper extremity function of single-port insufflation endoscopic nipple-sparing mastectomy (SIE-NSM) vs conventional open mastectomy (C-OM) in the treatment of early breast cancer. Methods In this retrospective cohort study, 285 stage I and II breast cancer patients were divided into the SIE-NSM group ( n = 71) and the C-OM group ( n = 214). Local recurrence, distant metastasis, and upper extremity function were compared. Differences in the aesthetic outcome, psychosocial well-being, and sexual well-being were analyzed by the BREAST-Q scale. Multivariable binary logistic regression was conducted to assess the risk of local recurrence. The multivariable linear regression model was performed to evaluate the upper extremity function and the aesthetic outcome. Results Local recurrence rates were similar ( p = 0.735), which was also shown by multivariable binary logistic regression analysis. No distant metastases were observed in either group. Satisfaction with breasts, chest well-being, psychosocial well-being, and sexual well-being scores were superior in the SIE-NSM group ( p < 0.001). Chest wall/breast pain, shoulder range of motion, and use of arm in daily life was better for the patients in the SIE-NSM group (p < 0.001). There were no cases of subcutaneous effusion in the SIE-NSM group, while the incidence rate of subcutaneous effusion in the C-OM group was 10.7% ( p = 0.004). Conclusions SIE-NSM is comparable to C-OM in oncologic safety while increasing satisfaction with breasts, physical well-being, psychosocial well-being, sexual well-being, and upper extremity function. This novel method is an appropriate surgical option for early breast cancer treatment.