Pluta Piotr, Rathat Gauthier, Blay Lydia, Gentilini Oreste Davide, Huber Daniela Emanuela, Daniel Martinez, Guillermo Peralta, Rami J Younan, Glenn Vergauwen, Antonio Toesca
Department of Surgical Oncology and Breast Diseases, Polish Mother's Memorial Hospital - Research Institute, Łódź, Poland.
Breast Surgery Unit, University Hospital, Montpellier, France.
Prz Menopauzalny. 2025 Mar;24(1):66-71. doi: 10.5114/pm.2025.150082. Epub 2025 May 3.
Minimal access nipple-sparing mastectomy (M-NSM), performed with endoscopic systems or with surgical robot assistance, is a novel alternative to the classic approach to nipple-sparing mastectomies. Leading advancements in M-NSM have primarily come from Asia. We gather experts' opinions from six European countries to establish the current status of M-NSM in Europe. An eight-question survey was designed to explore M-NSM's historical background and current standing in various local settings. We collected data from 6 European countries, including Italy, Spain, France, Switzerland, Belgium, and Poland. The number of centers offering M-NSM procedures in each reported country ranges 1-9. The number of procedures performed annually in four centers exceeds 10. In all reported countries, current national breast cancer recommendations do not include M-NSM, and this procedure is not explicitly covered by any of the national health care providers. All experts have indicated the need for training in M-NSM surgery as a primary way to incorporate these techniques as a standard procedure. Minimal access nipple-sparing mastectomy is still a tool used by a narrow group of specialists in Europe. The main obstacle to broader implementation remains the extra cost of M-NSM, which requires reimbursement from the health care providers. Training courses, data collection, and demonstration of its benefits are the key to promoting M-NSM among breast surgeons and patients.
采用内镜系统或手术机器人辅助进行的微创保乳手术（M-NSM）是经典保乳手术方法的一种新选择。M-NSM的主要进展主要来自亚洲。我们收集了来自六个欧洲国家专家的意见，以确定M-NSM在欧洲的现状。设计了一份包含八个问题的调查问卷，以探究M-NSM的历史背景及其在不同地区的现状。我们收集了来自意大利、西班牙、法国、瑞士、比利时和波兰这六个欧洲国家的数据。每个报告国家中提供M-NSM手术的中心数量在1至9个之间。四个中心每年进行的手术数量超过10例。在所有报告的国家中，当前国家乳腺癌治疗建议均未包括M-NSM，且该手术未被任何国家医疗服务提供者明确涵盖。所有专家均表示，需要进行M-NSM手术培训，这是将这些技术纳入标准手术的主要途径。微创保乳手术在欧洲仍然是一小部分专家使用的技术。更广泛应用的主要障碍仍然是M-NSM的额外费用，这需要医疗服务提供者给予报销。培训课程、数据收集以及证明其益处是在乳腺外科医生和患者中推广M-NSM的关键。
