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Updated: Sep 20, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Consensus Statement on Robotic Nipple Sparing Mastectomy Expert Panel
Jai Min Ryu1, Chi Wei Mok2,3, Antonio Toesca4
1Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Purpose:
Since the last consensus statement on robotic nipple-sparing mastectomy (RNSM) in 2019, this technique has gained popularity, with accumulating evidence supporting its feasibility and patient satisfaction. However, concerns regarding the technical challenges and patient selection persist. This study aimed to provide an updated consensus on RNSM.
Methods:
An international panel of 10 expert surgeons was convened to develop a consensus covering six domains: indications, contraindications, technical considerations, patient counseling, outcome measures, and training. The panel was asked to vote on statements via two rounds of online surveys and a final in-person meeting at the Global Breast Cancer Conference in conjunction with the International Endoscopic and Robotic Breast Surgery Symposium. Consensus was defined as 80% agreement with each statement.
Results:
A total of 53 statements with at least 80% agreement were generated after three rounds of voting. Most statements were updated from previous consensus statement. All experts agreed that the consensus statement serves as a set of expert recommendations for the successful and safe practice of robotic mastectomy but are not mandatory actions.
Conclusion:
Although still evolving, RNSM is a promising technique representing the future of minimally invasive breast surgery. This international consensus statement offers expert recommendations for safe and effective RNSM practices.
