Abstract
Breast-conserving surgery with sentinel node (SN) biopsy is recognized as the standard treatment for early breast cancers. We have reported the cosmetic merits and reduced complication rate achieved with video-assisted breast surgery (VABS). We devised a trans-axillary retro-mammary (TARM) approach to VABS. This approach requires only a single skin incision in the axilla and can be used to treat any tumor, even in the medial or caudal part of the breast, without incising and thus scarring the breast skin or altering sensation.
We have performed VABS in 300 patients since December 2001. The TARM approach was used in 120 patients with early breast cancer (stage I or II). After endoscopic sentinel node biopsy, the axillary skin incision was extended to 2.5 cm. The pectoral fascia behind the tumor was then dissected. The proximal side of the tumor was excised vertically, and the skin overlying the tumor was dissected. The tumor was then excised on the opposite side and extracted. Breast reconstruction was done with oxidized cellulose.
This approach was successful in all cases. All surgical margins were negative. There was no significant difference in the complication rate between the TARM method and the conventional VABS method. The reconstruction procedure required no excessive detachment of the skin outside the surgical margin. The natural shape of the breast was maintained in all 120 patients. The aesthetic results were excellent, and sensory disturbance was minimal. All patients were satisfied with the operation.
VABS performed via the TARM approach in patients with breast cancer provides an excellent cosmetic outcome and is rated favorably by patients.
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© 2014 Springer Japan
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Yamashita, K. (2014). Breast Surgery. In: Mori, T., Dapri, G. (eds) Reduced Port Laparoscopic Surgery. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54601-6_42
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DOI: https://doi.org/10.1007/978-4-431-54601-6_42
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