Single breast incision for breast conservation surgery and sentinel lymph node biopsy: a systematic review.

Summary

This PRISMA-guided systematic review found that single-incision breast-conserving surgery with sentinel node biopsy is feasible across all breast quadrants. Compared with two-incision approaches, complications were similar, while patient satisfaction and postoperative axillary pain favored the single-incision technique.

Key Findings

• Feasible single-incision access across all breast quadrants for BCS and SLNB
• Eight studies reported successful axillary dissection through a single incision
• Four comparative studies showed no difference in complication rates vs. two-incision techniques
• Single-incision approach improved patient satisfaction and reduced postoperative axillary pain

Clinical Implications

Single-incision breast-conserving surgery with SLNB can be considered for tumors in any quadrant to minimize scars and pain while maintaining safety; however, long-term oncologic outcomes require further confirmation.

Limitations

• Heterogeneity of included studies and techniques with limited standardization
• Lack of randomized trials and limited long-term oncologic outcome data

Future Directions

Prospective randomized trials with standardized cosmetic and quality-of-life metrics and long-term oncologic follow-up.