Visual analysis of minimally invasive surgery for breast cancer: a bibliometric analysis

Breast minimally invasive techniques are increasingly applied to breast cancer surgery, with the advantages of a small incision, minor trauma and aesthetics while treating the disease, contributing to improving the life quality of breast cancer patients. The main objective of this study was to explore and discuss the trends and hotspots in minimally invasive techniques for breast cancer surgery (MIBCS) from the last decade with bibliometric analysis, providing reference for exploration of new orientations for future research in that field. Related articles were searched from the Web of Science database, the collected data was analyzed on software to generate visualization knowledge maps. Bibliometric indicators covered publications, h-index, institutions, journals, authors, keywords, and research hotspots. China was ranked the highest for number of articles, followed by USA. The top five authors with the most publications were from Changhua Christian Hospital in Taiwan, who have contributed the most to MIBCS. The main hotspots were minimally invasive reconstruction, nipple-sparing mastectomy, and conserving surgery, with the postoperative results as the key research trend. From this study, Taiwan is the region of most contribution involving the number of publications, authors, journals, and institutions. Minimally invasive development still remains the core of MIBCS. At present, endoscopic nipple-sparing mastectomy with immediate reconstruction has been well established. Endoscopic robot assisted surgery will be tried to be adopted by more doctors. The evaluation of postoperative results will exist throughout the time.

Breast cancer; Minimally invasive; Surgery; Bibliometric; Trend

[1] Bishop SN, Selber JC. Minimally invasive robotic breast reconstruction surgery. Gland Surgery. 2021; 10: 469–478.

[2] Hung WK, Ying M, Chan CM, Lam HS, Mak KL. Minimally invasive technology in the management of breast disease. Breast Cancer. 2009; 16: 23–29.

[3] Mátrai Z, Gulyás G, Kunos C, Sávolt A, Farkas E, Szollár A, et al. Minimally invasive breast surgery. Orvosi Hetilap. 2014; 155: 162–169.

[4] Noguchi M. Minimally invasive surgery for small breast cancer. Journal of Surgical Oncology. 2003; 84: 94–101.

[5] Franceschini G, Visconti G, Garganese G, Barone-Adesi L, Di Leone A, Sanchez AM, et al. Nipple-sparing mastectomy combined with endoscopic immediate reconstruction via axillary incision for breast cancer: a preliminary experience of an innovative technique. The Breast Journal. 2020; 26: 206–210.

[6] Kinoshita S, Kyoda S, Hirano A, Akiba T, Nojima K, Uchida K, et al. Clinical comparison of four types of skin incisions for skin-sparing mastectomy and immediate breast reconstruction. Surgery Today. 2014; 44: 1470–1475.

[7] Stanec Z, Žic R, Budi S, Stanec S, Milanović R, Vlajčić Z, et al. Skin and nipple-areola complex sparing mastectomy in breast cancer patients. Annals of Plastic Surgery. 2014; 73: 485–491.

[8] Zhang M, Shen G, Zhang S, Cui Z, Qian J. Advantages of the modified double ring areolar incision over the traditional areolar incision in multicentric breast fibroadenoma surgery. Thoracic Cancer. 2017; 8: 423–426.

[9] Lai HW, Chen ST, Chen DR, Chen SL, Chang TW, Kuo SJ, et al. Current trends in and indications for endoscopy-assisted breast surgery for breast cancer: results from a six-year study conducted by the Taiwan endoscopic breast surgery cooperative group. Plos One. 2016; 11: e0150310.

[10] Shin H. Current trends in and indications for endoscopy-assisted breast surgery for breast cancer. Advances in Experimental Medicine and Biology. 2021; 122: 567–590.

[11] Neves S, Barbosa B, Carlos V. Digital influencers: a bibliometric analysis. International Workshop on Tourism and Hospitality Management. 2019; 130–132.

[12] Tomaszewska E. ‘Bibliometric analysis of scientific publications on smart city in international literature’. 24th International Scientific Conference on Economic and Social Development-Managerial Issues in Modern Business. Varazdin Development & Entrepreneurship Agency: Warsaw, Poland. 2017.

[13] Hao KJ, Jia X, Dai WT, Huo ZM, Zhang HQ, Liu JW, et al. Mapping intellectual structures and research hotspots of triple negative breast cancer: a bibliometric analysis. Frontiers in Oncology. 2022; 11: 689553.

[14] Fornazin M, Penteado BE, Castro L, S Luís. ‘From medical informatics to digital health: a bibliometric analysis of the research field’. 27th Annual Americas Conference on Information Systems (AMCIS). Association for Information Systems: Atlanta, USA. 2021.

[15] Hao T, Chen X, Li G, Yan J. A bibliometric analysis of text mining in medical research. Soft Computing. 2018; 22: 7875–7892.

[16] Maggio LA, Ninkov A, Frank JR, Costello JA, Artino AR. Delineating the field of medical education: bibliometric research approach(es). Medical Education. 2022; 56: 387–394.

[17] Corsini F, Frey M, Rizzi F. ‘Recent trends in E-waste research A bibliometric map approach’. World Congress on Sustainable Technologies (WCST-2012). Institute of Electrical and Electronics Engineers: London, UK. 2012.

[18] van Eck NJ, Waltman L. Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics. 2010; 84: 523–538.

[19] Abhishek, Srivastava M. Mapping the influence of influencer marketing: a bibliometric analysis. Marketing Intelligence & Planning. 2021; 39: 979–1003.

[20] Lyu X, Peng W, Yu W, Xin Z, Niu S, Qu Y. Sustainable intensification to coordinate agricultural efficiency and environmental protection: a systematic review based on metrological visualization. Journal of Land Use Science. 2021; 16: 313–338.

[21] Pang T, Shen J. Visualizing the landscape and evolution of capacitive deionization by scientometric analysis. Desalination. 2022; 527: 115562.

[22] Sidhu AS, Singh S, Kumar R. Bibliometric analysis of entropy weights method for multi-objective optimization in machining operations. Materials Today: Proceedings. 2022; 50: 1248–1255.

[23] Bromberg S, Figueiredo P, Ades F. Comparing conventional breast conserving surgery with the minimally invasive approach technique to treat early breast cancer—a retrospective case control study. The Breast. 2019; 44: S112.

[24] Rubio IT, Klinberg V. Minimally invasive techniques in breast cancer treatment. European Journal of Cancer Supplements. 2004; 2: 120.

[25] Wang Z, Ng H, Teng C, Ge Z, Gao G, Gao Y, et al. Outcomes of single-port gasless laparoscopic breast-conserving surgery for breast cancer: an observational study. The Breast Journal. 2019; 25: 461–464.

[26] Luo C, Wei C, Guo W, Yang J, Sun Q, Wei W, et al. 17-Year Follow-up of comparing mastoscopic and conventional axillary dissection in breast cancer: a multicenter, randomized controlled trial. Advances in Therapy. 2022; 39: 2961–2970.

[27] Singh S, Agarwal AA, Singh KR, Sonkar AA, Khuswaha JK, Singh A. et al. “Usefulness of endoscopic breast-conserving surgery for breast cancer” Surgery Today in November (2014) 44: 2037–2044. Surgery Today. 2015; 45: 1071–1072.

[28] Takahashi H, Fujii T, Nakagawa S, Inoue Y, Akashi M, Toh U, et al. Usefulness of endoscopic breast-conserving surgery for breast cancer. Surgery Today. 2014; 44: 2037–2044.

[29] Peralta-Castillo GG, Cavazos-García R, Eulalia-Hernández E, Cornejo-Mota LM, Santiago-Prieto AC. Single port endoscopic mastectomy: surgical technique and first case in Mexico. Cirugia Y Cirujanos. 2020; 88: 108–112.

[30] Houvenaeghel G, Bannier M, Rua S, Barrou J, Heinemann M, Van Troy A, et al. Breast cancer robotic nipple sparing mastectomy: evaluation of several surgical procedures and learning curve. World Journal of Surgical Oncology. 2019; 17: 27.

[31] Morrow M. Robotic mastectomy: the next major advance in breast cancer surgery? British Journal of Surgery. 2021; 108: 233–234.

[32] Toesca A, Peradze N, Manconi A, Lichosik D, Rietjens M, Veronesi P. Robotic nipple sparing mastectomy and immediate breast reconstruction: Future prospectives for breast cancer surgery. European Journal of Cancer. 2016; 57: S72–S72.

[33] Gui Y, Chen Q, Li S, Yang X, Liu J, Wu X, et al. ASO visual abstract: safety and feasibility of minimally invasive (laparoscopic/robotic-assisted) nipple-sparing mastectomy combined with prosthesis breast reconstruction in breast cancer—a single-center retrospective study. Annals of Surgical Oncology. 2022; 29: 4066–4066.

[34] Toesca A, Peradze N, Manconi A, Galimberti V, Intra M, Colleoni M, et al. Robotic nipple-sparing mastectomy for the treatment of breast cancer: feasibility and safety study. The Breast. 2017; 31: 51–56.

[35] Lai H, Wang C, Lai Y, Chen C, Lin S, Chen S, et al. The learning curve of robotic nipple sparing mastectomy for breast cancer: an analysis of consecutive 39 procedures with cumulative sum plot. European Journal of Surgical Oncology. 2019; 45: 125–133.

[36] Loh Z, Wu T, Cheng FT. Evaluation of the learning curve in robotic nipple-sparing mastectomy for breast cancer. Clinical Breast Cancer. 2021; 21: e279–e284.

[37] Lai H, Chen S, Mok CW, Chang Y, Lin S, Lin Y, et al. Single-port three-dimensional (3D) videoscope-assisted endoscopic nipple-sparing mastectomy in the management of breast cancer: technique, clinical outcomes, medical cost, learning curve, and patient-reported aesthetic results from 80 preliminary procedures. Annals of Surgical Oncology. 2021; 28: 7331–7344.

[38] Tang P, Hu Y, Wang Z, Gao G, Qu X, Jiang J. Clinical practice guidelines for endoscopic breast surgery in patients with early-stage breast cancer: Chinese Society of Breast Surgery (CSBrS) practice guidelines 2021. Chinese Medical Journal. 2021; 134: 2532–2534.

[39] Malur S, Bechler J, Schneider A. Endoscopic axillary lymphadenectomy without prior liposuction in 100 patients with invasive breast cancer. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2001; 11: 38–41.

[40] Wang Z, Qu X, Teng C, Ge Z, Zhang H, Yuan Z, et al. Preliminary results for treatment of early stage breast cancer with endoscopic subcutaneous mastectomy combined with endoscopic sentinel lymph node biopsy in China. Journal of Surgical Oncology. 2016; 113: 616–620.

[41] Ho WS, Ying SY, Chan ACW. Endoscopic-assisted subcutaneous mastectomy and axillary dissection with immediate mammary prosthesis reconstruction for early breast cancer. Surgical Endoscopy and other Interventional Techniques. 2002; 16: 302–306.

[42] Hung CS, Chang SW, Liao LM, Huang CC, Tu SH, Chen ST, et al. The learning curve of endoscopic total mastectomy in Taiwan: a multi-center study. Plos One. 2017; 12: e0178251.

[43] Wang Z, Xin P, Qu X, Zhang Z. Breast reconstruction using a laparo-scopically harvested pedicled omental flap after endoscopic mastectomy for patients with breast cancer: an observational study of a minimally invasive method. Gland Surgery. 2020; 9: 676–688.

[44] Antonini G, Busetto GM, De Berardinis E, Giovannone R, Vicini P, Del Giudice F, et al. Minimally invasive infrapubic inflatable penile prosthesis implant for erectile dysfunction: evaluation of efficacy, satisfaction profile and complications. International Journal of Impotence Research. 2016; 28: 4–8.

[45] Chau JKM, Hoy M, Tsui B, Harris JR. Minimally invasive parathyroidectomy under local anesthesia: patient satisfaction and overall outcome. Journal of Otolaryngology-Head & Neck Surgery. 2010; 39: 361–369.

[46] Morales NO, Fernández EGD, Nicolau BFA. Assessment of scar satisfaction and quality of sexual life after conservative surgical treatment. Our experience. Revista Internacional De Andrologia. 2019; 17: 155–158. (In Spanish)

[47] Singh S, Sardhara J, Mehrotra A, Behari S. Letter to the Editor. Patient satisfaction after minimally invasive spine surgery. Neurosurgical Focus. 2020; 49: E17.

[48] Franceschini G, Scardina L, Di Leone A, Terribile DA, Sanchez AM, Magno S, et al. Immediate prosthetic breast reconstruction after nipple-sparing mastectomy: traditional subpectoral technique versus direct-to-implant prepectoral reconstruction without acellular dermal matrix. Journal of Personalized Medicine. 2021; 11: 153.

[49] Manrique OJ, Kapoor T, Banuelos J, Jacobson SR, Martinez-Jorge J, Nguyen MT, et al. Single-stage direct-to-implant breast reconstruction. Annals of Plastic Surgery. 2020; 84: 361–365.

[50] Mirhaidari SJ, Azouz V, Wagner DS. Prepectoral versus subpectoral direct to implant immediate breast reconstruction. Annals of Plastic Surgery. 2020; 84: 263–270.

[51] van Mulken TJM, Schols RM, Scharmga AMJ, Winkens B, Cau R, Schoenmakers FBF. et al. First-in-human robotic supermicrosurgery using a dedicated microsurgical robot for treating breast cancer-related lymphedema: a randomized pilot trial. Nature Communication. 2020; 11: 757.