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Updated: Jun 23, 2026

Longitudinal Intravital Imaging Through Clear Silicone Windows
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"Moving window" operation for breast-conserving surgery.

Masakuni Noguchi1, Masashi Inokuchi

  • 1Department of Breast Oncology, Kanazawa University Hospital, Takara-machi, Japan. nogumasa@med.kanazawa-u.ac.jp

Breast Cancer (Tokyo, Japan)
|April 24, 2009
PubMed
Summary
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The involvement of axillary reverse mapping nodes in patients with node-positive breast cancer.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·2023

This study introduces a minimally invasive breast cancer surgery technique using a wound retractor, reducing operating time and blood loss compared to endoscopic methods. The transareolar and transaxillary approaches offer excellent cosmetic outcomes for eligible patients.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Surgery

Background:

  • Endoscope-assisted partial mastectomy improves cosmetic outcomes but can be cumbersome, increasing operating time and blood loss.
  • This method also necessitates the use of expensive disposable endoscopic instruments.
  • Alternative minimally invasive techniques are sought to optimize breast cancer surgery.

Purpose of the Study:

  • To evaluate the efficacy and safety of a novel surgical approach for breast-conserving surgery.
  • To assess the feasibility of using a wound retractor for partial mastectomy and axillary lymph node dissection.
  • To compare the outcomes of this technique with traditional endoscope-assisted procedures.

Main Methods:

  • Partial mastectomy and axillary lymph node dissection were performed on 58 patients using a wound retractor and bipolar scissors via small periareolar (transareolar) and/or axillary (transaxillary) incisions.

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  • This approach avoided the use of disposable endoscopic instruments.
  • The technique was applied to patients with noninvasive or invasive breast cancer.

    • Main Results:

    • Average surgical duration was 132 minutes for the transareolar approach and 125 minutes for the transaxillary approach.
    • Average blood loss was 38 ml and 48 ml, respectively.
    • Histological confirmation of negative margins was achieved in 97% of patients (56/58), with excellent postoperative cosmetic appearance in most cases.

    Conclusions:

    • A wound retractor facilitates breast-conserving surgery through small incisions, offering maximum exposure with minimal invasiveness.
    • This technique can reduce operating time and blood loss compared to endoscope-assisted partial mastectomy.
    • The transareolar and transaxillary approaches are suitable for patients with a mobile, adequately sized nipple-areola complex.