Innovative surgery option for breast cancer treatment

Canadian women with breast cancer, or at high-risk of developing the disease, now have the option of an innovative surgery that was once only available outside the country.

Surgeons at UHN’s Sprott Department of Surgery, at Toronto General Hospital, have conducted Canada’s first robotic-assisted nipple-sparing mastectomy.

This ground-breaking surgery has the potential for greater benefits – including reduced complication rates (such as lack of blood supply to the skin and nipple) at less than one percent compared to the 10 to 20 per cent that is standard in a traditional open nipple-sparing mastectomy. It could also result in a very minimal scar in the underarm area.

“One of the challenges in the open nipple-sparing mastectomy is the ability to visualize the extent of the breast tissue, especially the farther you get from the incision,” says Dr. Tulin Cil (pictured). “The robotic approach allows us to have a better view and more precise access to the entire breast tissue that needs to be removed.

“This has the potential to actually improve the surgery we do.”

This novel surgery was only offered in a few select centres around the world when a generous patient decided Canadian women shouldn’t have to leave home to access the procedure.

The donor (who prefers to remain anonymous) supported Dr. Cil, a surgical oncologist at UHN, to obtain the best training possible with Dr. Benjamin Sarfati in Paris, to be able to offer this through a first-of-its-kind Canadian clinical trial.

Dr. Sarfati is a pioneer in this new application of robotics and has performed more than 100 robotic mastectomies. Most recently, he was part of an expert panel that released a consensus statement on the safety of the procedure.

“The donor was passionate and determined about making this treatment option available here at Toronto General Hospital,” says Dr. Cil.

The costs are higher for robotic assisted surgeries. The robots themselves and the expensive disposables required for each surgery are not currently funded by the province of Ontario. This is where philanthropy is essential in fueling leading-edge innovation.

Dr. Cil performed the first nipple-sparing minimally invasive robotic mastectomy in Canada at TGH with visiting surgeon, Dr. Sarfati, who came to UHN to participate in this surgery with Dr Cil and her team.

For the team at UHN, this is just the beginning. Dr. Cil and her co-investigators in plastic surgery, Drs. Stefan Hofer and Anne O’Neill, hope to enroll 20 to 30 patients in the trial over the next year. The goal is to establish a state-of-the-art program in robotic breast surgery that will incorporate excellence in clinical care, cutting-edge research and surgical education.