Abstract
Background......Video-assisted breast conserving surgery (VA-BCS) was originated and developed in Japan. This method of surgery is applied in the breast cancer without skin infiltration of the cancer and makes skin incisions at inconspicuous area performing video-assisted skin sparing partial mastectomy (space SSPM). This method brings about an excellent cosmetic result. We report our long term result in this procedure here.
Materials and Methods......The indication of VA-BCS is for the breast cancer without skin infiltration of the cancer. The sites for the skin incisions are either in para-areolar area or on mid-axillarly line. The dissection of the mammary gland is carried out using video-assisted subcutaneous tunneling method and lifting method, achieving skin sparing partial mastectomy (SSPM). The defect of the mammary gland is replaced with autologous tissue as needed for the reconstruction of the breast. VA-BCS were performed in 142 patients (StageI : 56, StageII : 86) between Nov., 1999 and March, 2003. Evaluation of the postoperative complications, prognoses and degrees of patients' satisfaction of the procedure were performed.
Results......As the postoperative complications, skin necrosis in 6 (4.2%) and necrosis of fat and muscle flaps in 5 (3.5%) were observed, but no major complications. In the follow-up of average of 70 months, local recurrence were seen in 7 (4.9%). The distant metastasis free survival (DMFS) rate in 60 months was 92.7% in StageIand 90.7% in StageII. The overall survival (OS) rate was 94.5% in StageIand 97.4% in StageII. 71.7% of the patients were satisfied with the procedure and cosmesis.
Conclusion......Video-assisted breast conserving surgery does not result in increase of local recurrence rate, but results in good DMFS rate, OS rate and high grade of patients' satisfaction. As a local treatment of breast cancer, we believe this method is sure tobe an excellent modality of treatment.
