Outcomes of robotic nipple-sparing mastectomy versus conventional nipple-sparing mastectomy in women with breast cancer: a systematic review and meta-analysis

Authors

Gabriel De la Cruz-Ku, Department of Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA. gabrieldelacruzku@gmail.com.
Diego Chambergo-Michilot, Universidad Científica del Sur, Lima, Perú.
Armando Perez, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Bryan Valcarcel, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Larissa Pamen, Department of Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
David Linshaw, Department of Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Abhishek Chatterjee, Division of Surgical Oncology, Division of Plastic Surgery, Tufts Medical Center/Tufts School of Medicine, Boston, MA, USA.
Jennifer LaFemina, Department of Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Judy C. Boughey, Department of Surgery, Mayo Clinic, Rochester, MN, USA.

Document Type

Journal Article

Publication Date

2-20-2023

Journal

Journal of robotic surgery

DOI

10.1007/s11701-023-01547-5

Keywords

Breast; Breast cancer; Mastectomy; Meta-analysis (source: MeSH NLM); Nipple; Systematic review

Abstract

The promising results of the robotic approach for multiple cancer operations has led to interest in the potential of robotic nipple-sparing mastectomy (R-NSM); however, further studies are required to compare the benefits and complications of this approach with those of conventional open nipple-sparing mastectomy (C-NSM). We performed a meta-analysis to compare surgical complications of R-NSM versus C-NSM. We performed a review of literature through June 2022 in PubMed, Scopus, and EMBASE. We included randomized controlled trials (RCTs), cohorts, case-control studies, and case series with > 50 patients comparing the two techniques. Separate meta-analyses were conducted according to study design. From 80 publications, we identified six studies. The sample size ranged from 63 to 311 mastectomies from 63 to 275 patients. The tumor size and disease stage were similar between groups. The positive margin rate was 0-4.6% in the R-NSM arm and 0-2.9% in the C-NSM arm. Four studies reported early recurrence data, which were similar between groups (R-NSM: 0%, C-NSM: 0-8%). The R-NSM group had a lower rate of overall complications compared to the C-NSM group in cohorts/RCTs (RR = 0.68, 95%CI 0.49-0.96). In case-control studies, rate of necrosis was lower with R-NSM. Operative time was significantly longer in the R-NSM group in cohort/RCTs. In early experience with R-NSM, R-NSM had a lower overall complication rate compared to C-NSM in cohorts/RCTs. While these data are promising, our results show variability and heterogeneity limiting definitive conclusions. Additional trials are needed to guide the role of R-NSM and its oncologic outcomes.

APA Citation

De la Cruz-Ku, Gabriel; Chambergo-Michilot, Diego; Perez, Armando; Valcarcel, Bryan; Pamen, Larissa; Linshaw, David; Chatterjee, Abhishek; LaFemina, Jennifer; and Boughey, Judy C., "Outcomes of robotic nipple-sparing mastectomy versus conventional nipple-sparing mastectomy in women with breast cancer: a systematic review and meta-analysis" (2023). GW Authored Works. Paper 2377.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2377

Department

Public Health Student Works