Residual Breast Tissue
After Robot-Assisted Nipple Sparing Mastectomy
The Breast:
VOLUME 55, P25-29, FEBRUARY 01,
2021
by Ko Un Park, Gary H. Tozbikian, David J. Ferry RNFA, Allan
Tsung, Mathew D. Chetta, Steven A. Schulz, Roman J. Skoracki
Highlights
•Robot-assisted nipple sparing mastectomy (RNSM) is
technically feasible.
•Residual breast tissue after RNSM is histologically
detected only from the periareolar location.
•Further clinical trials are underway to determine oncologic
safety of RNSM.
Introduction
While the long-term oncologic safety of robot-assisted
nipple sparing mastectomy (RNSM) remains to be elucidated, histologically
detected residual breast tissue (RBT) can be a surrogate for oncologically
sound mastectomy. The objective of this study is to determine the presence of
RBT after RNSM.
Methods
Between August 2019–January 2020, we completed 5 cadaveric
RNSMs. Full thickness biopsies from the mastectomy skin flap were obtained from
predefined locations radially around the mastectomy skin envelop and nipple
areolar complex to histologically evaluate for RBT.
Results
The first case was not technically feasible due to inability
to obtain adequate insufflation. Five mastectomy flaps were analyzable. The
average mastectomy flap thickness was 2.3 mm (range 2–3 mm) and the
average specimen weight was 382.72 g (range 146.9–558.3 g). Of 70
total biopsies, RBT was detected in 11 (15.7%) biopsies. Most common location
for RBT was in the nipple-areolar complex, with no RBT detected from the peripheral
skin flaps.
Conclusions
In this cadaveric study, RNSM is feasible leaving minimal
RBT on the mastectomy flap. The most common location for RBT is in the
periareolar location consistent with previous published findings after open
NSM. Clinical studies are underway to evaluate the safety of RNSM.
