Our Summary

This research paper talks about the increased use of robots in breast cancer surgery, specifically in a procedure called nipple sparing mastectomy (NSM). The paper explores the safe use, benefits and potential drawbacks of robotic NSM (r-NSM) compared to traditional NSM (c-NSM).

The limited data available suggests that using robots for this surgery could mean smaller cuts and better cosmetic results. It also might be easier on the surgeon. The rate of complications during the procedure seems to be similar whether robots or traditional methods are used.

In terms of cancer outcomes, the short-term results look promising for robotic surgery, but more research is needed to confirm this in the long term. One major concern is that robotic surgery is more expensive than traditional methods. Whether or not this procedure can be widely adopted due to its cost is something that needs to be looked into.

Trials are currently being done to further investigate the potential benefits, cancer outcomes, and cost-effectiveness of robotic breast surgery.

FAQs

  1. What are the potential advantages of robotic nipple sparing mastectomy (r-NSM) over conventional open-NSM (c-NSM)?
  2. Are the complication rates for r-NSM and c-NSM similar?
  3. What are the considerations regarding the increased cost of r-NSM compared to open surgery and the feasibility of its widespread adoption?

Doctor’s Tip

A helpful tip a doctor might tell a patient about robotic surgery is to discuss the potential benefits, risks, and limitations of the procedure compared to traditional open surgery. It is important for patients to understand that while robotic surgery may offer smaller incisions and improved cosmesis, it is still a relatively new technology with limited long-term data on oncologic outcomes. Patients should also be aware of the increased cost of robotic surgery compared to traditional surgery and discuss whether this is a feasible option for them. As always, it is important for patients to ask questions and have an open dialogue with their healthcare provider to make informed decisions about their treatment options.

Suitable For

Patients who are typically recommended for robotic surgery in breast procedures include those with early-stage breast cancer who are eligible for nipple sparing mastectomy, as well as those with benign breast conditions such as fibroadenomas. Robotic surgery may also be recommended for patients who are interested in potential benefits such as smaller incisions, improved cosmesis, and faster recovery times. Patients with certain anatomical considerations, such as small breasts or dense breast tissue, may also be good candidates for robotic surgery. Additionally, patients who are concerned about the potential for improved ergonomics and reduced surgeon fatigue may benefit from robotic-assisted procedures. However, it is important for patients to discuss their individual circumstances and treatment options with their healthcare provider to determine if robotic surgery is the best choice for their specific situation.

Timeline

Before Robotic Surgery:

  • Patient is diagnosed with breast cancer and consults with a surgeon to discuss treatment options
  • Patient and surgeon decide on robotic nipple sparing mastectomy (r-NSM) as the preferred surgical approach
  • Patient undergoes preoperative evaluations and tests to ensure they are a suitable candidate for robotic surgery
  • Surgery is scheduled and patient receives instructions on how to prepare for the procedure

After Robotic Surgery:

  • Patient undergoes r-NSM using robotic technology, which allows for smaller incisions and potential for improved cosmesis
  • Patient experiences similar periprocedural complication rates as with conventional open-NSM
  • Short-term oncologic follow-up is reassuring, but long-term outcomes are still being investigated
  • Patient may experience faster recovery and less pain compared to traditional open surgery
  • Patient may have improved cosmetic outcomes and potentially reduced risk of complications such as infection
  • Patient may need follow-up appointments and additional treatments such as radiation therapy or chemotherapy, depending on the stage of their cancer.

What to Ask Your Doctor

  1. What are the potential benefits of undergoing robotic-assisted surgery for my specific condition compared to traditional open surgery?
  2. What are the potential risks or complications associated with robotic surgery in breast procedures?
  3. How experienced are you and your team in performing robotic-assisted breast surgeries?
  4. What is the recovery time like for robotic surgery compared to traditional open surgery?
  5. Will I have a scar after undergoing robotic nipple sparing mastectomy, and if so, how noticeable will it be?
  6. How will my follow-up care and monitoring be different after undergoing robotic surgery compared to traditional surgery?
  7. Are there any specific criteria or factors that would make me a good or poor candidate for robotic-assisted breast surgery?
  8. How does the cost of robotic surgery compare to traditional open surgery, and will my insurance cover the procedure?
  9. What are the long-term oncologic outcomes and survival rates associated with robotic-assisted breast surgery compared to traditional surgery?
  10. Are there any ongoing clinical trials or research studies investigating the effectiveness and safety of robotic breast surgery that I should be aware of?

Reference

Authors: Doll A, Kopkash K, Baker J. Journal: Clin Breast Cancer. 2024 Jun;24(4):286-291. doi: 10.1016/j.clbc.2023.12.009. Epub 2024 Jan 9. PMID: 38220537