Nipple-sparing mastectomy (NSM) is a type of surgery used to reduce the risk of breast cancer development in high-risk patients with minimal scarring and satisfactory cosmetic results.
To determine the benefits of using robotic systems for NSM compared to traditional open surgical techniques, physicians at the European Institute of Oncology recently published a study consisting of 73 women who underwent robotic NSM (RNSM) between 2014 and 2019. Indications for surgery included invasive breast cancer, ductal carcinoma in situ (DCIS), or carrying the BRCA mutation without a cancer diagnosis.
The results of the study indicate that RNSM is associated with a number of benefits to both surgeons and patients, compared to traditional open mastectomy procedures. Benefits to surgeons include enhanced visualisation and access to areas of the breast tissue that are difficult to reach. This is a result of robotic arms being able to access tissue at angles that are not possible using retractors for open surgery. In turn, the enhanced incision range of robotic arms allows for more favourable cosmetic outcomes. Therefore, patients were more satisfied with the results of their surgeries. Furthermore, the complication rates, relapse rates, disease-free survival, and overall survival after RNSM were comparable to open surgery.
However, RNSM took more than an hour longer to perform compared to open surgery. The RNSM procedures lasted around 3.5 hours, while open mastectomies were completed in an average of 2.25 hours. This extra time will be associated with additional costs for NSM.
In 2019 GlobalData estimated the market for robotic surgical systems and disposable components to be $3B in the US and growing at a Compound Annual Growth Rate of 10.6%. Currently, robotic surgery for a mastectomy is not approved by the FDA due to limited data on safety and effectiveness. However, the rising popularity of robotic surgery is likely to stimulate additional studies to assess the benefits of RNSM and to determine if this technique is worth the increased costs associated with this technology.