Endoscopic Breast-Conserving Surgery with Sentinel Lymph Node Biopsy for Early-Stage Breast Cancer: Initial Indian Experience

Background Endoscopic breast-conserving surgery (EBCS) seeks to improve cosmetic outcomes while preserving oncological safety. Although widely reported in East Asia, the technique is rarely documented in India. We present an initial Indian series of EBCS combined with sentinel lymph node biopsy (SLNB) performed through a single concealed axillary incision. Methods Between January and March 2025, three women with biopsy-proven, clinically node-negative early invasive breast carcinoma underwent EBCS with SLNB. A single axillary incision was used for resection and axillary staging with CO₂ insufflation and ultrasonic dissection. Outcomes included operative parameters, complications, margin status, cosmetic satisfaction, and short-term oncologic follow-up. Results All cases were completed endoscopically without conversion. Mean operative time was 145 minutes and mean blood loss 60 ml. All margins were negative. One patient developed a minor seroma managed conservatively. Median hospital stay was one day. Cosmetic satisfaction averaged 4.6/5. At a median follow-up of 6 months, all patients remained disease-free. Conclusion EBCS with SLNB is feasible and safe in carefully selected Indian patients, providing high cosmetic satisfaction with oncologic adequacy in the short term. Larger series with longer follow-up are required.