Technical feasibility and short-term outcomes of single-incision endoscopic breast-conserving surgery with sentinel lymph node biopsy: initial Indian experience.

BACKGROUND

Endoscopic breast-conserving surgery (EBCS) aims to offer improved cosmetic outcomes while maintaining oncologic safety. Although well established in East Asian programs¹⁻³, its use remains uncommon in India⁴. This pilot feasibility series describes early Indian experience with EBCS and sentinel lymph node biopsy (SLNB) performed entirely through a single concealed axillary incision.

METHODS

Three consecutive women with biopsy-proven, clinically node-negative early invasive carcinoma underwent single-incision EBCS with SLNB between January and March 2025. The technique used CO₂ insufflation, a glove-port system, and ultrasonic dissection. Primary outcomes included operative parameters, margin status, sentinel node retrieval, and perioperative complications. Secondary outcomes were seroma, drain duration, pain scores, recovery milestones, and cosmetic satisfaction using a 5-point Likert scale. Follow-up was recorded individually for each patient.

RESULTS

All cases were completed endoscopically without conversion. Mean operative time was 145 min (range 130-160), and blood loss averaged 60 ml. Margins were negative in all three patients. One minor seroma resolved with conservative management. No wound infections, skin necrosis, dimpling, or lymphedema occurred. At a median follow-up of nine months, all patients remained disease-free. Cosmetic satisfaction was high (average Likert 4.6/5), with preserved breast contour and no visible deformity.

CONCLUSIONS

Single-incision EBCS with SLNB is feasible, safe, and cosmetically favourable in selected Indian patients offering oncologic adequacy. While early outcomes are reassuring, larger series, longer follow-up, and validated PROMs such as BREAST-Q are required to better define the technique's role in routine oncologic practice.