We spoke with Lisa Wiechmann, MD, breast surgeon at the Comprehensive Breast Center at NewYork-Presbyterian/Columbia University Irving Medical Center, about a new approach to mastectomy that uses robotic technology.
Robotic nipple-sparing mastectomy uses precision instrumentation and high-resolution camera guidance to remove breast tissue while preserving the nipple-areolar complex and healthy breast skin. This minimally invasive approach is an option for certain patients with breast cancer and those at high risk of developing the disease.
NewYork-Presbyterian/Columbia Brings Transformative New Approach to Breast Surgery to New York City Area
How does this new approach differ from a traditional mastectomy?
Preliminary reports suggest that sensation in the breast skin and nipple may be better preserved with this approach. One possible reason is that the technique minimizes pressure on the skin, nipple, and nerves. Rather than using a metal or plastic retractor, we use air to create the space needed to perform the procedure.
What are the benefits of keeping the nipple intact?
Preserving the nipple can produce a more natural-looking breast after reconstruction, which is an important consideration for many patients.
How does using a robotic platform improve results?
There is very little manual retraction. Instead, air is introduced at a controlled pressure to create the space we need to operate. The technique is a lot gentler on the tissues compared with a standard approach, and better for the skin, nipple, and surrounding nerves.
Who is a candidate for this procedure?
Patients who are candidates for nipple-sparing mastectomy may also be candidates for the robotic approach, including many patients who carry genetic mutations associated with an increased risk of breast cancer, as well as patients with peripheral tumors located toward the outer areas of the breast. Ultimately, eligibility depends on breast size and the anticipated outcome of reconstruction.
What should patients who are interested in having this surgery look for in a surgeon?
Patients should look for someone with a lot of nipple-sparing mastectomy experience and a good reconstructive surgeon. I perform approximately two nipple-sparing mastectomies a week.
Robotic nipple-sparing mastectomy is still a very new procedure, and only a few surgeons across the country have significant experience with the technique. NewYork-Presbyterian/Columbia is among the first centers in the Northeast to offer it. We were selected by Intuitive, the company behind the robotic system, following an extensive evaluation of our experience, reputation, and surgical program. An important part of that program is our two-surgeon approach, with Dr. Johnson and me working together on these procedures.
Related:
- State of the Union: Breast Care Today
- For Many Breast Cancers, There Is No Advantage to Mastectomy
- New Breast Cancer Guidelines Say Mammograms Should Start at Age 40