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05 December 2019 : Case report  France

Endoscopic Nipple-Sparing Mastectomy with Immediate Prepectoral Implant-Based Reconstruction: A Case Report

Unusual setting of medical care

Gauthier Rathat1ADE, Christian Herlin2A, Christophe Bonnel3AD, Guillaume Captier4AE, Martha Duraes1ADE*

DOI: 10.12659/AJCR.919669

Am J Case Rep 2019; 20:1812-1816

Abstract

BACKGROUND: Technical innovations allow endoscopic nipple-sparing mastectomy (NSM), which is well tolerated and associated with greater patient satisfaction. Endoscopic technique did not have wide diffusion; many centers have abandoned this technique because of technical challenges. Implant-based reconstruction (IBR) remains the most common form of breast reconstruction. Current techniques involve partial or total coverage of the implant with pectoralis major muscle to prevent exposure or infection. Muscle dissection has functional and cosmetic consequences.

CASE REPORT: We present a case of 45-year-old patient presenting with personal history of right breast cancer. The patient requested left prophylactic mastectomy. We used a 4 cm-long single hidden scar on axillary line. Endoscopic nipple-sparing mastectomy was done using a single port with 3 sleeves. Immediate breast reconstruction was performed by inserting a silicon implant in prepectoral plane without Acellular Dermal Matrix (ADM). At 6 months postoperatively, no complication had been reported. The patient was satisfied with the result and no further correction was necessary.

CONCLUSIONS: Endoscopic surgery is a valuable option for nipple-sparing mastectomy. This method is a less expensive alternative technique to robotic approach. It could enable safe prepectoral IBR without placement of ADM and with lower risk of complications.

Keywords: Breast Implantation, Mammaplasty, Mastectomy, Subcutaneous, Breast Implants, Breast Neoplasms, Nipples, Organ Sparing Treatments, Prophylactic mastectomy

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923