Robotic Mastectomy Marks New Milestone in Breast Cancer Care in the Mountain West

A surgical team from Huntsman Cancer Institute at the University of Utah (the U) has performed the first robotic mastectomy in the Mountain West, a cutting-edge procedure that minimizes scarring and shortens recovery time for certain breast cancer patients. Huntsman Cancer Institute is one of only a few cancer centers across the country where the nipple-sparing robotic operation is offered.

“Operating on a woman’s breast is very impactful to her overall welfare, her sexual health, and her emotional well-being. I sometimes think the overall emotional impact is not as talked about and maybe not as much anticipated as it really ends up being,” says Kelly Hewitt, MD, FACS, the Huntsman Cancer Institute surgeon and associate professor of surgery at the U who performed the operation. “One thing I hear over and over again from my patients is that they don’t want a daily reminder that they had breast cancer. This procedure gives them the chance to look in the mirror and not see their scars, which means a lot to them.”

Nipple-sparing mastectomies are operations that allow surgeons to remove the tumor and produce better cosmetic results for patients. Surgeons keep the overlying skin, including the nipple and areola, while removing the underlying breast tissue. Patients can then undergo breast reconstruction with a plastic surgeon, if they so choose. These operations are most commonly done as open surgeries, requiring physicians to make large incisions around 8–10 centimeters in the fold underneath the breast or on the side of the breast. But Hewitt says that scar can sometimes move up or down and become more visible, depending on where the implant sits.

The single-port robotic nipple-sparing mastectomy works in a similar way to open surgery, but the robotic method allows the surgeon to make a much smaller, 3.5-centimeter incision near the armpit.

“Robotic surgery makes the scarring far less visible. After a patient heals, it almost looks as if they just had a mole removed,” says Hewitt, who underwent extensive training to perform the operation.

Monica Del Valle-Serena, a 48-year-old mother of four from Fort Hall, Idaho, was the first patient to have the procedure. Her breast cancer appeared on a routine mammogram in the spring, and she traveled 2.5 hours to Huntsman Cancer Institute for treatment.

Hewitt told Del Valle-Serena that she would be a good candidate for a robotic mastectomy, as the procedure is best for individuals with early-stage breast cancers. But Hewitt was also transparent that this procedure was a new approach, and Del Valle-Serena could choose other breast surgery options to treat her cancer.

Ultimately, the robotic approach appealed to Del Valle-Serena as the quicker recovery time would make life easier caring for her family, including two teenagers and two children under 10. Patients who undergo a robotic mastectomy can be up and about the next day, though it takes around 3–4 weeks to fully heal.

“My father also had cancer, and he’s now in remission after going through a clinical trial. I knew that there are innovative approaches out there, and sometimes it may be worth trying something new,” says Del Valle-Serena. “Having the opportunity to do the robotic mastectomy felt providential, and I decided to go for it. I’m glad I did.”

Del Valle-Serena had infiltrating ductal carcinoma, which forms in the milk ducts and accounts for 80% of breast cancers. Though the tumor was only in her right breast, she opted for a bilateral mastectomy. After Hewitt removed the breast tissue, she and her team inserted balloon-like tissue expanders as a temporary implant.

“Leaving surgery, I still had my breasts. I was surprised, because you just don’t know what to expect,” says Del Valle-Serena. “You don’t know what you’re going to look like, and I still looked like myself. It felt great.”

Del Valle-Serena's tumor was removed, and she will soon begin hormone therapy. She will also return to Huntsman Cancer Institute in August for breast reconstruction. In the future, Huntsman Cancer Institute surgeons hope to be able to perform the robotic mastectomy and the full breast reconstruction all in one day for appropriate patients.

“As a dedicated cancer center, Huntsman Cancer Institute wants to push the envelope and offer the most cutting-edge surgical techniques for our patients. Robotic mastectomies are not widely available across the country, and providing this service will expand treatment options for our patients in the Mountain West,” says Clark Gamblin, MD, MS, MBA, FACS, surgical oncologist at Huntsman Cancer Institute and chief of the Division of Surgical Oncology at the U. “The robotic approach allows us to tailor treatment to each breast cancer patient while prioritizing safety, recovery, and long-term well-being.”

Sachin Apte, MD, MS, MBA is the chief clinical officer and physician-in-chief at Huntsman Cancer Institute and professor of obstetrics and gynecology at the U.

“Emerging surgical techniques like robotic mastectomies are transforming breast cancer care, and I’m excited that our patients will now have this option,” says Apte. “Introducing this procedure at Huntsman Cancer Institute represents an important step forward in providing top-level care for our patients throughout the area we serve.”