7-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complications
Abstract Background Single-port endoscopic nipple-sparing mastectomy (E-NSM) with implant-based breast reconstruction (IBBR) represents a promising surgical technique. However, the surgical procedures are complex and lack standardized and systematic surgical protocols. The seven-step method was intr...
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BMC
2025-07-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-025-03935-7 |
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| author | Ze Huang Zhijie Wu Xiaoyan Fu Yonghai Guo Siyuan Lin Jieying Chen Zongyan Li Zuxiao Chen Haiyan Li |
| author_facet | Ze Huang Zhijie Wu Xiaoyan Fu Yonghai Guo Siyuan Lin Jieying Chen Zongyan Li Zuxiao Chen Haiyan Li |
| author_sort | Ze Huang |
| collection | DOAJ |
| description | Abstract Background Single-port endoscopic nipple-sparing mastectomy (E-NSM) with implant-based breast reconstruction (IBBR) represents a promising surgical technique. However, the surgical procedures are complex and lack standardized and systematic surgical protocols. The seven-step method was introduced as a means of simplifying the complex surgical procedures, with detailed descriptions provided of the key points and critical aspects of the surgery. Methods The medical records of patients who received single-port E-NSM with IBBR guided by the seven-step method from January 2022 to March 2024 were analyzed. The preliminary results were presented. Results A total of 65 patients were enrolled in the study, who received 93 procedures of single-port E-NSM with IBBR following the seven-step method. The mean age was 41.7 ± 8.2 years, and the mean body mass index (BMI) was 22.81 ± 3.5 kg/m2. All patients had breasts of C cup size or smaller. One case required nipple-areola complex (NAC) removal due to tumor involvement, while no involvement of the surgical margins was detected. The mean operative time was 258.6 ± 71.2 min, and the mean intraoperative blood loss was 27.7 ± 20.5 ml. The overall complication rate was 8.6%, with six cases (6.5%) of nipple partial ischemia observed. No case experienced nipple necrosis. All reported complications were classified as minor. In Breast-Q “Satisfaction with Breasts” module, the mean score was 65.7 ± 18.0. The “physical well-being of chest” score was 73.9 ± 13.6. All four sensory types of the nipple—light touch, temperature, pressure, and pain—as well as erectile function, were preserved at favorable rates following the procedure. As of the last follow-up, no patients experienced local recurrence, distant metastasis, or mortality. Conclusions Single-port E-NSM with IBBR, guided by the seven-step method, is a safe and feasibility surgical approach. It is associated with a low complication rate, good cosmetic outcomes, and reasonable preservation of nipple sensation and erectile function. This technique appears particularly suitable for patients with breast sizes of C cup or smaller. The proposed seven-step method may provide a valuable framework for clinical practice and serve as a practical reference for peers, thereby contributing to the establishment of standardized and systematic surgical protocols. |
| format | Article |
| id | doaj-art-7da7f085f2374523b0ac7b18c84cfa67 |
| institution | Kabale University |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | World Journal of Surgical Oncology |
| spelling | doaj-art-7da7f085f2374523b0ac7b18c84cfa672025-08-20T03:43:02ZengBMCWorld Journal of Surgical Oncology1477-78192025-07-0123111410.1186/s12957-025-03935-77-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complicationsZe Huang0Zhijie Wu1Xiaoyan Fu2Yonghai Guo3Siyuan Lin4Jieying Chen5Zongyan Li6Zuxiao Chen7Haiyan Li8Department of General Surgery (Breast Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of General Surgery (Breast Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of General Surgery (Breast Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of General Surgery (Breast Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen UniversityThe Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical UniversityThe Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical UniversityDepartment of General Surgery (Breast Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of General Surgery (Breast Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen UniversityDepartment of General Surgery (Breast Surgery), The Sixth Affiliated Hospital, Sun Yat-Sen UniversityAbstract Background Single-port endoscopic nipple-sparing mastectomy (E-NSM) with implant-based breast reconstruction (IBBR) represents a promising surgical technique. However, the surgical procedures are complex and lack standardized and systematic surgical protocols. The seven-step method was introduced as a means of simplifying the complex surgical procedures, with detailed descriptions provided of the key points and critical aspects of the surgery. Methods The medical records of patients who received single-port E-NSM with IBBR guided by the seven-step method from January 2022 to March 2024 were analyzed. The preliminary results were presented. Results A total of 65 patients were enrolled in the study, who received 93 procedures of single-port E-NSM with IBBR following the seven-step method. The mean age was 41.7 ± 8.2 years, and the mean body mass index (BMI) was 22.81 ± 3.5 kg/m2. All patients had breasts of C cup size or smaller. One case required nipple-areola complex (NAC) removal due to tumor involvement, while no involvement of the surgical margins was detected. The mean operative time was 258.6 ± 71.2 min, and the mean intraoperative blood loss was 27.7 ± 20.5 ml. The overall complication rate was 8.6%, with six cases (6.5%) of nipple partial ischemia observed. No case experienced nipple necrosis. All reported complications were classified as minor. In Breast-Q “Satisfaction with Breasts” module, the mean score was 65.7 ± 18.0. The “physical well-being of chest” score was 73.9 ± 13.6. All four sensory types of the nipple—light touch, temperature, pressure, and pain—as well as erectile function, were preserved at favorable rates following the procedure. As of the last follow-up, no patients experienced local recurrence, distant metastasis, or mortality. Conclusions Single-port E-NSM with IBBR, guided by the seven-step method, is a safe and feasibility surgical approach. It is associated with a low complication rate, good cosmetic outcomes, and reasonable preservation of nipple sensation and erectile function. This technique appears particularly suitable for patients with breast sizes of C cup or smaller. The proposed seven-step method may provide a valuable framework for clinical practice and serve as a practical reference for peers, thereby contributing to the establishment of standardized and systematic surgical protocols.https://doi.org/10.1186/s12957-025-03935-7The seven-step methodEndoscopic nipple-sparing mastectomySingle portBreast reconstructionBreast cancerNipple sensation |
| spellingShingle | Ze Huang Zhijie Wu Xiaoyan Fu Yonghai Guo Siyuan Lin Jieying Chen Zongyan Li Zuxiao Chen Haiyan Li 7-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complications World Journal of Surgical Oncology The seven-step method Endoscopic nipple-sparing mastectomy Single port Breast reconstruction Breast cancer Nipple sensation |
| title | 7-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complications |
| title_full | 7-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complications |
| title_fullStr | 7-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complications |
| title_full_unstemmed | 7-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complications |
| title_short | 7-step endoscopic nipple-sparing mastectomy with implant-based breast reconstruction: nipple sensation preservation and low complications |
| title_sort | 7 step endoscopic nipple sparing mastectomy with implant based breast reconstruction nipple sensation preservation and low complications |
| topic | The seven-step method Endoscopic nipple-sparing mastectomy Single port Breast reconstruction Breast cancer Nipple sensation |
| url | https://doi.org/10.1186/s12957-025-03935-7 |
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