Background:Breast cancer is the most common malignancy in female patients. In recent years, more and more studies have focused on how to improve the appearance and the quality of life for patients. This study aimed to compare the oncologic safety, aesthetic results, and upper extremity function between single-port insufflation endoscopic nipple-sparing mastectomy (SIE-NSM) and conventional open mastectomy (C-OM) in early-stage breast cancer treatment.Methods:In our retrospective cohort, 285 patients with stage I and II breast cancer were categorized into the SIE-NSM group (n=71) and the C-OM group (n=214). We assessed local recurrence, distant metastasis, and upper extremity function across the two groups. The BREAST-Q scale was employed to analyze differences in aesthetic results, psychosocial well-being, and sexual health. The risk of local recurrence was evaluated using multivariable binary logistic regression, while a multivariable linear regression model gauged upper extremity function and aesthetic outcomes.Results:Local recurrence rates between the two groups were statistically similar (1/71, 1.4% for SIE-NSM vs. 2/214, 0.9% for C-OM, P=0.735), as confirmed by the multivariable binary logistic regression analysis. Neither group exhibited distant metastases. The SIE-NSM group demonstrated higher scores in satisfaction with breasts, chest wellness, psychosocial health, and sexual well-being (P<0.001). The SIE-NSM group also exhibited superior outcomes regarding chest wall/breast pain, shoulder mobility, and daily arm usage (P<0.001). No subcutaneous effusion was reported in the SIE-NSM group, whereas the C-OM group had a 10.7% incidence rate (P=0.004).Conclusions:SIE-NSM offers comparable oncologic safety to C-OM but provides enhanced satisfaction regarding breast appearance, physical comfort, psychosocial health, sexual health, and improved upper extremity functionality. Consequently, this innovative approach is a suitable surgical alternative for treating early-stage breast cancer.

Objective:To discuss the oncologic safety, aesthetic outcome, and upper extremity function of single-port insufflation endoscopic nipple-sparing mastectomy (SIE-NSM) in the treatment of early breast cancer.Methods:From January 2014 to August 2019, a total of 80 patients with stage Ⅰ and Ⅱ breast cancer underwent SIE-NSM, at Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed and followed up. Estimated the oncologic safety, aesthetic outcome, and upper extremity function.Results:SIE-NSM was performed successfully on all 80 patients.There was no serious complication after surgery.The follow-up time was 16-82 months and the median follow-up time was 42 months. Local recurrence occurred in two patients, and there was no distant metastases. Four (5%) patients developed grade 1-3 nipple-areola complex ischemia. There were no cases of subcutaneous effusion.The satisfaction with breasts, chest well-being, psychosocial well-being, and sexual well-being scores were confirmed to be highly rated by Breast-Q scale. Upper extremity function score confirmed that good upper limb function was preserved after surgery. The mean length of incision was (3.6±0.8) cm, and the blood loss was (24.7±19.3) mL.Conclusions:SIE-NSM can achieve a higher cosmetic score and a better recovery of upper limb function on the premise of ensuring the safety of the tumor.This novel method is an appropriate surgical option for patients with early breast cancer.