Fellow Leads Robotic Single-Port Mastectomy and Achieves US First

A 45-year-old woman with aggressive triple-negative breast cancer has become the first patient in the US outside a clinical trial to undergo a robotic single-port nipple-sparing mastectomy.

The procedure, performed March 9 at Sutter Health’s Alta Bates Summit Medical Center in Oakland, California, demonstrates the expanding application of robotic platforms to oncologic breast surgery while highlighting the potential for improved functional and cosmetic outcomes.

Rita Kwan-Feinberg, MD, MPH, FACS, performed the operation using the da Vinci SP single-port robotic system, which provides access through a single small incision. The platform’s articulating instruments and enhanced visualization are designed to facilitate precise dissection within anatomically constrained spaces while limiting the external surgical footprint. In nipple-sparing mastectomy, this approach may be particularly valuable for preserving the nipple-areolar complex and minimizing visible scarring.

The patient had been diagnosed with rapidly progressive, node-positive triple-negative breast cancer and underwent chemotherapy and immunotherapy before surgery.

According to Sutter, the mastectomy achieved oncologic removal while leaving the external appearance of the breast largely unchanged. Potential advantages of the approach include reduced visible scarring, preservation of nipple sensation, and potentially lower rates of skin and nipple-areolar tissue necrosis. These benefits remain important areas for clinical investigation rather than established superiority over conventional techniques.

The case also illustrates the broader scientific question surrounding robotic mastectomy: whether the technical capabilities of single-port platforms can translate into measurable improvements in surgical morbidity, patient-reported outcomes, quality of life, and oncologic safety. The robotic platform has received FDA clearance for nipple-sparing mastectomy, but long-term outcomes remain under evaluation.

The patient’s rapid postoperative recovery underscores the potential patient-centered benefits of minimally invasive breast surgery. However, broader adoption will require prospective evidence defining patient selection, complication rates, operative efficiency, costs, oncologic outcomes, and durability of reconstructive and sensory benefits.

The procedure represents an important technical milestone, but its ultimate significance will depend on whether robotic precision can produce clinically meaningful advantages beyond improved cosmesis and patient experience.