A challenging therapeutic method for breast cancer: Non-lipolytic endoscopic axillary surgery through periareolar incisions

Surgical treatment of breast cancer is becoming increasingly precise, less invasive, and more cosmetically pleasing. Sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) remain the standard treatment methods for breast cancer. However, these methods still require incisions in the breasts or axilla. Mastoscopic axillary lymph node dissection (MALND) surgery, although first reported several years ago, has not been widely used as it involves lipolysis. Non-lipolytic mastoscopy may be more appealing; however, the lack of a cavity in the breast and the abundant fat and glands make this procedure challenging. In addition, incision of the trocar in the axilla has been shown to have no advantage over traditional breast-conserving surgery. The present study describes 16 cases of non-lipolytic endoscopic axillary surgery without incisions in the axilla.