关键词: 术中导航, 乳腺癌, 腔镜, 保乳手术

Abstract: Background A growing number of Chinese breast cancer patients are diagnosed at a young age. The quality of life of young breast cancer patients has been a critical issue. Breast-conserving surgery （BCS） not only removes the tumor but also maintains the appearance of breast. The Breast Tumor Center of Sun Yat-sen Memorial Hospital is one of the first departments in China to perform breast-conserving surgeries. Endoscopic breast surgery has emerged as a promising surgical approach. However, it is hard to delineate the tumor margins in endoscopic BCS, which restrains its development. In traditional BCS, surgeons determine the tumor border by palpation, which is impossible in endoscopic BCS. For the first time, we performed the intra-operative navigation system-assisted endoscopic breast-conserving surgery, in which the tumor border was accurately delineated using the navigation system. Patient A 46-year-old woman was diagnosed with left breast cancer with the stage of cT2N1M0 IIB. She asked the surgeons to maintain the breast appearance to the greatest extent. Methods Breast MR was performed to acquire the three-dimensional images. At the start of surgery, the spatial position of breast was acquired by scanning with O-arm device after skin preparation and draping. Then, we integrated the images and breast position in a real-time 3-dimensional model of Medtronic Stealth Station S7 Navigation System with the “3D Fusion” function. Finally, we used the probe to precisely mark the tumor border and excised the lump. Results The margins of the tumor were all negative in pathological assessment. The breasts looked basically symmetrical and the wound was invisible when viewed from the front. The patient was pleased with the appearance. Discussion Intra-operative navigation system-assisted endoscopic breast-conserving surgery achieves an easier operative procedure and a lower positive rate of surgical margin, which may vigorously promote the endoscopic BCS.

Key words: Intra-operative navigation, Breast cancer, Endoscopy, Breast conserving surgery