Impact of tumor-to-nipple distance on outcomes in robotic nipple-sparing mastectomy and reconstruction

Abstract Background Nipple-sparing mastectomy (NSM) has become a preferred surgical option for breast cancer patients due to its oncologic safety and aesthetic benefits. Robotic NSM (RNSM) offers enhanced precision and minimally invasive access, yet its feasibility in cases with a tumor-to-nipple di...

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Main Authors: Joon Suk Moon, Young Jin Lee, Tae Kyung Yoo, Jisun Kim, Il Yong Chung, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, Sae Byul Lee
Format: Article
Language:English
Published: Springer 2025-05-01
Series:Discover Oncology
Subjects:
Online Access:https://doi.org/10.1007/s12672-025-02736-4
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author Joon Suk Moon
Young Jin Lee
Tae Kyung Yoo
Jisun Kim
Il Yong Chung
Beom Seok Ko
Hee Jeong Kim
Jong Won Lee
Byung Ho Son
Sae Byul Lee
author_facet Joon Suk Moon
Young Jin Lee
Tae Kyung Yoo
Jisun Kim
Il Yong Chung
Beom Seok Ko
Hee Jeong Kim
Jong Won Lee
Byung Ho Son
Sae Byul Lee
author_sort Joon Suk Moon
collection DOAJ
description Abstract Background Nipple-sparing mastectomy (NSM) has become a preferred surgical option for breast cancer patients due to its oncologic safety and aesthetic benefits. Robotic NSM (RNSM) offers enhanced precision and minimally invasive access, yet its feasibility in cases with a tumor-to-nipple distance (TND) ≤ 1 cm remains unclear. This study evaluates the oncologic safety and surgical outcomes of RNSM in patients with TND ≤ 1 cm by comparing it with both RNSM in patients with TND > 1 cm and conventional NSM (CNSM) in patients with TND ≤ 1 cm. Methods A retrospective analysis of 1427 patients who underwent NSM with immediate reconstruction between October 2020 and October 2023 was conducted. Propensity score matching (PSM) was applied to compare three groups: TND ≤ 1 cm, RNSM vs. TND > 1 cm, RNSM and TND ≤ 1 cm, RNSM vs. TND ≤ 1 cm, CNSM. Oncologic safety was assessed by analyzing subareolar resection margin status, while surgical outcomes included postoperative complications such as nipple-areolar complex (NAC) necrosis. Result After PSM, no statistically significant differences were observed in subareolar resection margin results or the incidence of adverse events between the TND ≤ 1 cm and TND > 1 cm RNSM groups. Similarly, no significant differences were found in oncologic or surgical outcomes between RNSM and CNSM in patients with TND ≤ 1 cm. Conclusions RNSM is a safe and feasible option for patients with TND ≤ 1 cm, achieving oncologic outcomes comparable to CNSM in patients with TND ≤ 1 cm and RNSM in patients with TND > 1 cm. These findings suggest that TND ≤ 1 cm should not be a contraindication for RNSM. Further prospective studies with long-term follow-up are necessary to validate these results.
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spelling doaj-art-1fcc5ef456de41b8abf9a2a1214e0a9f2025-08-20T03:48:18ZengSpringerDiscover Oncology2730-60112025-05-0116111610.1007/s12672-025-02736-4Impact of tumor-to-nipple distance on outcomes in robotic nipple-sparing mastectomy and reconstructionJoon Suk Moon0Young Jin Lee1Tae Kyung Yoo2Jisun Kim3Il Yong Chung4Beom Seok Ko5Hee Jeong Kim6Jong Won Lee7Byung Ho Son8Sae Byul Lee9Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical CenterDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical CenterDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical CenterDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical CenterDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical CenterDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical CenterDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical CenterDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical CenterDivision of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical CenterAbstract Background Nipple-sparing mastectomy (NSM) has become a preferred surgical option for breast cancer patients due to its oncologic safety and aesthetic benefits. Robotic NSM (RNSM) offers enhanced precision and minimally invasive access, yet its feasibility in cases with a tumor-to-nipple distance (TND) ≤ 1 cm remains unclear. This study evaluates the oncologic safety and surgical outcomes of RNSM in patients with TND ≤ 1 cm by comparing it with both RNSM in patients with TND > 1 cm and conventional NSM (CNSM) in patients with TND ≤ 1 cm. Methods A retrospective analysis of 1427 patients who underwent NSM with immediate reconstruction between October 2020 and October 2023 was conducted. Propensity score matching (PSM) was applied to compare three groups: TND ≤ 1 cm, RNSM vs. TND > 1 cm, RNSM and TND ≤ 1 cm, RNSM vs. TND ≤ 1 cm, CNSM. Oncologic safety was assessed by analyzing subareolar resection margin status, while surgical outcomes included postoperative complications such as nipple-areolar complex (NAC) necrosis. Result After PSM, no statistically significant differences were observed in subareolar resection margin results or the incidence of adverse events between the TND ≤ 1 cm and TND > 1 cm RNSM groups. Similarly, no significant differences were found in oncologic or surgical outcomes between RNSM and CNSM in patients with TND ≤ 1 cm. Conclusions RNSM is a safe and feasible option for patients with TND ≤ 1 cm, achieving oncologic outcomes comparable to CNSM in patients with TND ≤ 1 cm and RNSM in patients with TND > 1 cm. These findings suggest that TND ≤ 1 cm should not be a contraindication for RNSM. Further prospective studies with long-term follow-up are necessary to validate these results.https://doi.org/10.1007/s12672-025-02736-4Nipple-sparing mastectomyRobotic nipple-sparing mastectomyConventional nipple-sparing mastectomyTumor-to-nipple distance
spellingShingle Joon Suk Moon
Young Jin Lee
Tae Kyung Yoo
Jisun Kim
Il Yong Chung
Beom Seok Ko
Hee Jeong Kim
Jong Won Lee
Byung Ho Son
Sae Byul Lee
Impact of tumor-to-nipple distance on outcomes in robotic nipple-sparing mastectomy and reconstruction
Discover Oncology
Nipple-sparing mastectomy
Robotic nipple-sparing mastectomy
Conventional nipple-sparing mastectomy
Tumor-to-nipple distance
title Impact of tumor-to-nipple distance on outcomes in robotic nipple-sparing mastectomy and reconstruction
title_full Impact of tumor-to-nipple distance on outcomes in robotic nipple-sparing mastectomy and reconstruction
title_fullStr Impact of tumor-to-nipple distance on outcomes in robotic nipple-sparing mastectomy and reconstruction
title_full_unstemmed Impact of tumor-to-nipple distance on outcomes in robotic nipple-sparing mastectomy and reconstruction
title_short Impact of tumor-to-nipple distance on outcomes in robotic nipple-sparing mastectomy and reconstruction
title_sort impact of tumor to nipple distance on outcomes in robotic nipple sparing mastectomy and reconstruction
topic Nipple-sparing mastectomy
Robotic nipple-sparing mastectomy
Conventional nipple-sparing mastectomy
Tumor-to-nipple distance
url https://doi.org/10.1007/s12672-025-02736-4
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