• Antonio Toesca, Claudia Sangalli, Patrick Maisonneuve, Giulia Massari, Antonia Girardi, Jennifer L Baker, Germana Lissidini, Alessandra Invento, Gabriel Farante, Giovanni Corso, Mario Rietjens, Nickolas Peradze, Alessandra Gottardi, Francesca Magnoni, Luca Bottiglieri, Matteo Lazzeroni, Emilia Montagna, Piergiorgio Labo, Roberto Orecchia, Viviana Galimberti, Mattia Intra, Virgilio Sacchini, and Paolo Veronesi.
• Division of Breast Surgery, European Institute of Oncology IRCCS, Milan, Italy.
• Ann. Surg. 2022 Jul 1; 276 (1): 11-19.

ObjectiveThe aim of this study was to compare robotic mastectomy with open classical technique outcomes in breast cancer patients.Summary Background DataAs the use of robotic nipple sparing mastectomy continues to rise, improved understanding of the surgical, oncologic, and quality of life outcomes is imperative for appropriate patient selection as well as to better understand indications, limits, advantages, and dangers.MethodsIn a phase III, open label, single-center, randomized controlled trial involving 80 women with breast cancer (69) or with BRCA mutation (11), we compared the outcome of robotic and open nipple sparing mastectomy. Primary outcomes were surgical complications and quality of life using specific validated questionnaires. Secondary objective included oncologic outcomes.ResultsRobotic procedure was 1 hour and 18 minutes longer than open (P < 0.001). No differences in the number or type of complications (P = 0.11) were observed. Breast-Q scores in satisfaction with breasts, psychosocial, physical and sexual well-being were significantly higher after robotic mastectomy versus open procedure. Respect to baseline, physical and sexual well-being domains remained stable after robotic mastectomy, whereas they significantly decreased after open procedure (P < 0.02). The overall Body Image Scale questionnaire score was 20.7 ± 13.8 versus 9.9 ± 5.1 in the robotic versus open groups respectively, P < 0.0001. At median follow-up 28.6months (range 3.7-43.3), no local events were observed.ConclusionsComplications were similar among groups upholding the robotic technique to be safe. Quality of life was maintained after robotic mastectomy while significantly decrease after open surgery. Early follow-up confirm no premature local failure.ClinicalTrials.gov NCT03440398.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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