Endoscopic Mastectomy: A Cost-effective and Time-efficient Alternative to Robotic Mastectomy with Comparable Oncologic and Safety Outcomes

초록

Goals: This study aimed to evaluate whether endoscopic mastectomy is a cost-effective and time-efficient alternative to robotic mastectomy, while maintaining comparable oncologic outcomes and safety profiles. Methods: A total of 110 patients who underwent either robotic (29 patients) or endoscopic (81 patients) nipple-sparing mastectomy between April 2019 and November 2024 at Korea University Ansan Hospital were included in this study. The primary outcomes assessed were surgical time, costs, length of hospital stay, amount of total drainage, complication rates, and oncologic outcomes. Statistical analysis was performed to compare the differences between the two groups. Results: There was a significant difference in both mastectomy time (RM 170.7 ± 55.2 minutes, EM 149.9 ± 40.2 minutes, p = 0.033) and plastic surgery time (RM 213.6 ± 110.1 minutes, EM 119.2 ± 77.9 minutes, p < 0.001) between the two groups, leading to a significant reduction in total operative time (RM 384.3 ± 113.0 minutes, EM 269.0 ± 89.0 minutes, p < 0.001). The cost of robotic mastectomy was significantly higher compared to the endoscopic approach (RM 31,338,659.0 ± 5,166,816.8 Korean Won, EM 19,486,521.5 ± 6,074,413.6 Korean Won, p < 0.001). No significant differences were S124 Poster Abstracts / The Breast 80S (2025) S1–S188 observed between the two groups regarding length of hospital stay, complication rates, or oncologic outcomes. Conclusions: Endoscopic mastectomy is a time-efficient and costeffective alternative to robotic mastectomy. Both approaches demonstrated comparable oncologic outcomes and safety profiles, suggesting that endoscopic mastectomy could be a viable option for breast cancer surgery.