Endoscopic Video-Assisted Nipple-Sparing Mastectomy (EVA)

May 28, 2026 updated by: European Institute of Oncology

EVA - Endoscopic Video-Assisted Nipple-Sparing Mastectomy (E-NSM): A Pilot Study

Endoscopic video-assisted nipple-sparing mastectomy (E-NSM) is an advancement in minimally invasive breast surgery designed to reduce surgical trauma and improve cosmetic outcomes while maintaining strict oncologic safety. The procedure will be carried out by a dedicated surgical team in which at least one operator holds certified laparoscopic surgical training issued by a recognized scientific society, ensuring appropriate technical expertise and adherence to surgical safety standards.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This pilot study aims to prospectively document the technical feasibility and perioperative outcomes of E-NSM performed according to an established institutional protocol, including standardized perfusion assessment using indocyanine green (ICG) angiography and patient-reported outcomes using BREAST-Q questionnaire. Data generated from this study will support refinement of the institutional protocol and inform the design of future comparative or multicentre trials.

Study Type

Interventional

Enrollment (Estimated)

10

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Italy
      • Milan, Italy, 20141
        • Recruiting
        • Istituto Europeo di Oncologia
        • Contact:
        • Principal Investigator:
          • Eleonora Meduri, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Female patients aged ≥18 years
  • Candidates for nipple-sparing mastectomy (NSM) with immediate reconstruction
  • Histologically confirmed invasive carcinoma cT1N0, or carriers of pathogenic germline mutations undergoing prophylactic mastectomy
  • Breast size I-III and absence of significant glandular ptosis
  • Signed informed consent

Exclusion Criteria:

  • Inflammatory breast cancer
  • Locally advanced clinical stage (cT2-T4 or N+)
  • Ductal carcinoma in situ (DCIS) without invasive component
  • Previous radiotherapy to the affected breast
  • Locoregional recurrence
  • Clinical conditions contraindicating prosthetic reconstruction
  • Indication for skin-sparing (SSM) or skin-reducing mastectomy (SRM)
  • Ongoing or completed neoadjuvant chemotherapy before surgery
  • Refusal or inability to sign informed consent
  • Inability to complete scheduled follow-up

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Endoscopic video-assisted nipple-sparing mastectomy (E-NSM)
All enrolled patients will undergo endoscopic video-assisted nipple-sparing mastectomy (E-NSM) with immediate breast reconstruction (implant-based or pre-planned alternative reconstruction).
Procedure: Endoscopic video-assisted nipple-sparing mastectomy (E-NSM)
Endoscopic video-assisted nipple-sparing mastectomy (E-NSM) is an advancement in minimally invasive breast surgery designed to reduce surgical trauma and improve cosmetic outcomes while maintaining strict oncologic safety. Recent prospective studies and meta-analyses have shown encouraging results in terms of technical feasibility, reduced flap-related complications, and higher patient satisfaction compared with the conventional open approach.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of completion of the procedure endoscopically without conversion to open surgery.
Time Frame: At surgery
Number of procedure not converted to open surgery on the total of study procedures.
At surgery
Surgery time
Time Frame: At surgery
Average and median duration of endoscopic dissection, including creation of the working space.
At surgery
Feasibility of immediate reconstruction
Time Frame: At surgery
The feasibility and type of immediate reconstruction performed (direct-to-implant or two stage) measured as the number immediate rescotruction on the number of total surgery performed.
At surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

European Institute of Oncology

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 23, 2026

Primary Completion (Estimated)

April 1, 2027

Study Completion (Estimated)

July 1, 2027

Study Registration Dates

First Submitted

April 30, 2026

First Submitted That Met QC Criteria

May 6, 2026

First Posted (Actual)

May 11, 2026

Study Record Updates

Last Update Posted (Actual)

June 1, 2026

Last Update Submitted That Met QC Criteria

May 28, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UID 5184
  • L2-605 (Other Identifier: Comitato Etico Territoriale Lombardia 2)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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