Single breast incision for breast conservation surgery and sentinel lymph node biopsy: a systematic review

TL;DR

This review shows that a single breast incision can safely perform breast cancer surgery and lymph node biopsy, improving patient satisfaction and reducing pain.

Contribution

The study systematically evaluates the feasibility and outcomes of single-incision breast surgery and sentinel lymph node biopsy.

Findings

The single-incision technique successfully accesses all breast quadrants and nodal basins.

Patient satisfaction and post-operative pain are improved with the single-incision approach.

Complication rates are similar to conventional two-incision techniques.

Abstract

Breast conservation surgery and sentinel lymph node biopsy via a single incision allows excision of tumours from all quadrants of the breast, with access to both axillary and internal mammary nodal basins with no additional incisions.

This systematic review aims to consolidate the current literature on the efficacy, safety, functional and cosmetic outcomes of single‐incision breast conserving surgery and sentinel lymph node biopsy.

A comprehensive search of Pubmed, EMBASE, Medline and GoogleScholar was conducted from inception to 7th July 2024 for all peer‐reviewed articles assessing breast conserving surgery and sentinel lymph node biopsy via single incision using PRISMA guidelines.

The literature search generated 426 articles. 400 were excluded by abstract review with the remaining 26 articles reviewed in full. An additional three articles were retrieved from review of full article reference lists. 13 articles were excluded, leaving 10 articles meeting the inclusion criteria. The technique demonstrated success across all quadrants of the breast. Eight studies documented successful axillary dissection completed via a single incision. Four studies compared the single‐incision approach to the conventional two‐incision technique. There was no difference in complication rates. The single‐incision technique was associated with higher patient satisfaction and reduced post‐operative axillary pain.

Single‐incision breast conservation surgery and sentinel lymph node biopsy is surgically safe and can be feasible for tumours in all quadrants of the breast and is associated with improvement in cosmesis, pain and patient satisfaction. Further studies are required to confirm its long‐term oncological safety.

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