Our Summary

This research paper is a thorough review of studies that focus on a surgical procedure called robot-assisted nipple-sparing mastectomy (a type of breast cancer surgery). Researchers looked at various sources, including databases like MEDLINE, Embase, Cochrane, and more, to find relevant studies. They screened over 7,000 titles and ended up including eight studies in their review.

These studies included data from 187 women who had undergone robot-assisted nipple-sparing mastectomy. The reasons for the surgery were either to treat existing breast cancer (therapeutic) or to prevent it in high-risk individuals (prophylactic). Almost all women had immediate reconstruction after the removal of the breast.

The researchers found that this kind of surgery is feasible and has acceptable outcomes in the short-term. However, there were some complications after surgery, including skin issues and complications related to the nipple. There were also two cases where the surgery had to be converted due to bleeding. No deaths occurred during the surgery.

The review found that there was no return of cancer in the local area for the duration of the follow-up period, which ranged from about 3 to 45 months. However, the researchers noted that the data on patient-reported outcomes and cosmetic results were not consistently reported. Also, no data was provided about nipple sensitivity after the surgery.

In conclusion, while robot-assisted nipple-sparing mastectomy appears to be a feasible option with acceptable short-term outcomes, it’s still in the experimental stage. More research is needed to evaluate long-term cancer outcomes and patient-reported outcomes in more comprehensive, randomized trials.

FAQs

  1. What is a robot-assisted nipple-sparing mastectomy and why is it performed?
  2. What were the findings of this review on robot-assisted nipple-sparing mastectomy?
  3. What are the potential complications of robot-assisted nipple-sparing mastectomy according to the reviewed studies?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mastectomy is to follow their post-operative care instructions closely to promote healing and reduce the risk of complications. This may include proper wound care, taking prescribed medications, attending follow-up appointments, and following any recommendations for physical activity and recovery. It’s important for patients to communicate any concerns or changes in their condition to their healthcare team for appropriate management.

Suitable For

Patients who are typically recommended for a mastectomy include those with:

  1. Early-stage breast cancer: Mastectomy may be recommended for patients with early-stage breast cancer, particularly if they have a tumor larger than 5 cm, have multiple tumors in the same breast, or have a genetic mutation that increases their risk of developing breast cancer.

  2. Ductal carcinoma in situ (DCIS): Patients with DCIS, a non-invasive form of breast cancer, may undergo a mastectomy to reduce the risk of the cancer recurring or progressing to invasive breast cancer.

  3. Genetic mutations: Patients with a strong family history of breast cancer or known genetic mutations, such as BRCA1 or BRCA2, may choose to undergo a prophylactic mastectomy to reduce their risk of developing breast cancer.

  4. Recurrent breast cancer: Patients who have had a previous breast cancer diagnosis and experience a recurrence may undergo a mastectomy as part of their treatment plan.

  5. Large tumors: Patients with large tumors that are not suitable for breast-conserving surgery or who have tumors located in multiple areas of the breast may be recommended for a mastectomy.

  6. Inflammatory breast cancer: Patients with inflammatory breast cancer, a rare and aggressive form of breast cancer, may require a mastectomy as part of their treatment plan.

  7. Patients who prefer mastectomy: Some patients may choose to undergo a mastectomy due to personal preference, anxiety about the risk of recurrence, or concerns about ongoing surveillance and screening.

It is important for patients to discuss their individual circumstances and treatment options with their healthcare provider to determine the most appropriate course of action.

Timeline

Before the mastectomy:

  • Patient may undergo various tests and consultations to determine the need for surgery
  • Decision-making process regarding the type of mastectomy and reconstruction options
  • Pre-operative preparations such as fasting, medication adjustments, and consent forms
  • Surgery day, where patient is admitted to the hospital and undergoes the procedure

After the mastectomy:

  • Recovery period in the hospital, typically a few days
  • Follow-up appointments with healthcare providers to monitor healing and address any complications
  • Rehabilitation and physical therapy to regain strength and mobility
  • Emotional support and counseling to cope with body image changes and potential complications
  • Long-term monitoring for any signs of cancer recurrence or other health issues

It’s important for patients to have a comprehensive care plan in place before and after mastectomy, which may include support from a multidisciplinary team of healthcare professionals.

What to Ask Your Doctor

Some questions a patient should ask their doctor about mastectomy include:

  1. What are the benefits and risks of robot-assisted nipple-sparing mastectomy compared to other types of mastectomy?
  2. What is the success rate of this procedure in terms of removing all cancerous tissue?
  3. How long is the recovery process after robot-assisted nipple-sparing mastectomy?
  4. What are the potential complications or side effects of this surgery?
  5. Will I need additional treatments, such as radiation or chemotherapy, after the mastectomy?
  6. What kind of follow-up care will be necessary after the surgery?
  7. How will my breast look and feel after the surgery, including nipple sensitivity?
  8. Are there any specific criteria that make me a good candidate for robot-assisted nipple-sparing mastectomy?
  9. Can you provide me with information about your experience and success rate with this type of surgery?
  10. Are there any alternative treatment options that I should consider?

Reference

Authors: Angarita FA, Castelo M, Englesakis M, McCready DR, Cil TD. Journal: Br J Surg. 2020 Nov;107(12):1580-1594. doi: 10.1002/bjs.11837. Epub 2020 Aug 26. PMID: 32846014