Endoscopic Skin-Sparing vs. Conventional Mastectomy for Wound Complications in BC
A Multicenter, Randomized, Controlled, Open-Label Study Comparing Endoscopic Skin-Sparing Mastectomy With Conventional Mastectomy for Wound Complications in Patients With Breast Cancer
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.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Shicheng Su
- Phone Number: +86 13631304227
- Email: sushch@mail.sysu.edu.cn
Study Locations
-
-
Guangdong
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Guangzhou, Guangdong, China, 510120
- Recruiting
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
-
Contact:
- Shicheng Su
- Phone Number: +86 13631304227
- Email: sushch@mail.sysu.edu.cn
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
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
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: E-SSM
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.
|
|
Active Comparator: CM
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.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Wound Complication Rate
Time Frame: occurring prior to completion of adjuvant chemotherapy and radiotherapy, about 6-12 months postoperatively
|
Wound complications are defined as wound dehiscence requiring surgical debridement, dressing change, or packing, or persistent wound discharge, occurring prior to completion of adjuvant chemotherapy and radiotherapy.
The rate is calculated as: (Number of patients with ≥1 wound complication / Total surgical patients in the group) × 100%
|
occurring prior to completion of adjuvant chemotherapy and radiotherapy, about 6-12 months postoperatively
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Patient Satisfaction
Time Frame: 6 months postoperatively
|
Breast satisfaction score from the Breast Q questionnaire at 6 months postoperatively.
Patients will complete the self-reported Breast Q survey under physician guidance, which takes 1-4 minutes for the breast satisfaction module and 10-15 minutes for the full survey.
|
6 months postoperatively
|
|
Postoperative Breast Appearance
Time Frame: 6 months postoperatively
|
Overall aesthetic score using the Ueda scale (0-10, 0=poor, 10=excellent) assessed by physicians, and scar appearance score using the Scar-Q scale (0-100, 4 domains) self-reported by patients, both evaluated at 6 months postoperatively.
|
6 months postoperatively
|
|
Surgical Time
Time Frame: intraoperative
|
Time from initial incision to completion of wound closure, measured in minutes.
|
intraoperative
|
|
Intraoperative Blood Loss
Time Frame: intraoperative
|
Total volume of blood lost during surgery, measured in milliliters (mL).
|
intraoperative
|
|
Rate of Other Postoperative Adverse Complications
Time Frame: up to 24 months
|
Percentage of patients experiencing other postoperative complications (e.g., edema, bleeding) during the follow-up period, calculated as: (Number of patients with ≥1 other complication / Total patients in the group) × 100%
|
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
|
Time from the date of surgery to death from any cause.
Patients who remain alive will be censored at the last follow-up date.
|
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.
|
Defined as the time from the date of surgery to the first occurrence of any of the following events: local recurrence, regional recurrence, distant metastasis, or death from any cause.
Patients without any event were censored at the last follow-up date.
|
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.
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Shicheng Su, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- SYSKY-2025-809-02
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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