Endoscopic Skin-Sparing vs. Conventional Mastectomy for Wound Complications in BC

Official title

A Multicenter, Randomized, Controlled, Open-Label Study Comparing Endoscopic Skin-Sparing Mastectomy With Conventional Mastectomy for Wound Complications in Patients With Breast Cancer

Overview

This randomized, open-label study compares endoscopic skin-sparing mastectomy (E-SSM) with conventional mastectomy (CM) in female patients with unilateral invasive breast cancer (T1-4aN0-3M0). The primary objective is to evaluate differences in postoperative wound complications and patient satisfaction, with secondary outcomes including breast appearance and oncological safety. Eligible patients have a breast volume ≤ cup C and no/mild ptosis (grade I-II). A total of 258 participants (129 per group) will be enrolled across multiple centers and randomized by site. This study aims to provide evidence for selecting optimal endoscopic surgical strategies, address the evidence gap for E-SSM without immediate reconstruction, and advance the precision of breast cancer surgery.

Interventions

• Procedure Endoscopic skin-sparing mastectomy
  Endoscopic skin-sparing mastectomy (E-SSM). Under endoscopic assistance, the breast skin and partial subcutaneous tissue are preserved, while the breast parenchyma, and nipple-areola complex are resected according to oncological principles. This approach aims to maintain breast envelope integrity while ensuring oncological safety.
• Procedure Conventional mastectomy
  Conventional mastectomy (CM). The breast tissue, nipple-areola complex, and a full thickness of skin and subcutaneous tissue within the traditional resection range are removed. This is the standard surgical approach for breast cancer.

Primary outcome measures

• Wound Complication Rate [Time frame: occurring prior to completion of adjuvant chemotherapy and radiotherapy, about 6-12 months postoperatively]

Secondary outcome measures (7)

• Patient Satisfaction [Time frame: 6 months postoperatively]
• Postoperative Breast Appearance [Time frame: 6 months postoperatively]
• Surgical Time [Time frame: intraoperative]
• Intraoperative Blood Loss [Time frame: intraoperative]
• Rate of Other Postoperative Adverse Complications [Time frame: up to 24 months]
• Overall Survival (OS) [Time frame: From date of surgery until the date of death from any cause, assessed up to 60 months]
• Disease-Free Survival (DFS) [Time frame: From date of surgery until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 60 months.]

Eligibility criteria

Inclusion criteria

• Female patients aged 18 to 75 years
• Pathologically confirmed invasive breast cancer
• Clinical stage cT1-4a N0-3 M0
• Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1
• Unilateral breast cancer
• Left ventricular ejection fraction (LVEF) ≥ 50%
• Hematological and renal function with the following parameters: White blood cell count ≥ 3.0 × 10⁹/L; Neutrophil count ≥ 1.5 × 10⁹/L; Platelet count ≥ 100 × 10⁹/L; Hemoglobin ≥ 90 g/L; Serum creatinine ≤ 1.5 × upper limit of normal (ULN)
• No planned breast reconstruction

Exclusion criteria

• Tumor invasion of the skin
• Diffuse malignant microcalcifications
• Breast cancer during pregnancy or lactation
• History of another primary malignancy
• Severe cardiopulmonary, hepatic or renal dysfunction, or other significant systemic diseases

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Treatment

Study locations

China · 1 center

• Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University — Guangzhou

Identifiers

NCT: NCT07548762 · SYSKY-2025-809-02

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗