title: Technical feasibility and cosmetic advantage of hybrid endoscopy-assisted breast-conserving surgery for breast cancer patients.
abstract: BACKGROUND
  We developed a new procedure called hybrid endoscopy-assisted breast-conserving surgery (EBCS), which consists of a combination of plastic surgery and endoscopic surgery techniques. The purpose of this study was retrospectively to analyze the clinical outcome of hybrid EBCS and compare the cosmetic outcomes between hybrid EBCS and conventional breast-conserving surgery (CBCS).
  
  
  METHODS
  We reviewed medical records of patients who had undergone hybrid EBCS (n=73) or CBCS (n=90) between May 2005 and April 2011 and had been followed up in our department until March 2012. The clinical outcomes and cosmetic outcomes of these two groups were compared. The safety of hybrid EBCS was also analyzed by confirming its complications and pathological surgical margin.
  
  
  RESULTS
  In the hybrid EBCS group, operation time was longer by 30-50 minutes. Blood loss was not significantly different between the two groups. The surgical margin of hybrid EBCS was as follows: 1 patient (1.4%) had a positive margin, 4 patients (5.5%) had a margin of <2 mm, in 9 patients (12.3%) the margin was ≥2 mm and <5 mm, and in 59 patients (80.8%) it was ≥5 mm. Seven cases (9.6%) of postoperative complications occurred in 6 hybrid EBCS patients. To date, no local recurrence has been observed in hybrid EBCS patients (postoperative observation period, 18.1±5.6 months). Compared with the CBCS group, the hybrid EBCS group had better cosmetic results, especially with a less noticeable operative scar (P<.01).
  
  
  CONCLUSIONS
  Hybrid EBCS can provide sufficient free margin, and its surgical curability is acceptable. Additionally, this method is superior to CBCS in terms of cosmetic outcome.
authors.affiliation: Department of Surgical Oncology Research, Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan. s-ozaki@bf7.so-net.ne.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Ozaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohara
authors.forename: Hideo
authors.initials: H
authors.lastname: Shigematsu
authors.forename: Tatsunari
authors.initials: T
authors.lastname: Sasada
authors.forename: Akiko
authors.initials: A
authors.lastname: Emi
authors.forename: Norio
authors.initials: N
authors.lastname: Masumoto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kadoya
authors.forename: Shigeru
authors.initials: S
authors.lastname: Murakami
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kataoka
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Fujii
authors.forename: Koji
authors.initials: K
authors.lastname: Arihiro
authors.forename: Morihito
authors.initials: M
authors.lastname: Okada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery*; D004724:Endoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies