Residual breast tissue after robot-assisted nipple sparing mastectomy
Ko Un Park, MD,
Gary H. Tozbikian, MD,
David Ferry, RNFA,
Allan Tsung, MD,
Mathew Chetta, MD,
Steven Schulz, MD,
Roman Skoracki, MD
Affiliations
Ko Un Park, MD
Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center James Cancer Hospital, Columbus, OH, USA; Corresponding author. Assistant Professor of Surgery The Ohio State University Wexner Medical Center The James Cancer Hospital 410 W 10th Ave, N908 Doan Hall Columbus, Ohio, 43210, USA.
Gary H. Tozbikian, MD
Department of Pathology, The Ohio State University Wexner Medical Center James Cancer Hospital, Columbus, OH, USA
David Ferry, RNFA
Robotic Surgery Program, The Ohio State University Wexner Medical Center James Cancer Hospital, Columbus, OH, USA
Allan Tsung, MD
Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center James Cancer Hospital, Columbus, OH, USA
Mathew Chetta, MD
Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center James Cancer Hospital, Columbus, OH, USA
Steven Schulz, MD
Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center James Cancer Hospital, Columbus, OH, USA
Roman Skoracki, MD
Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center James Cancer Hospital, Columbus, OH, USA
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.
