Minimally Invasive Breast Surgery: A narrative review on Current Indications, Techniques, Outcomes, and Future Directions

Abstract Minimally invasive breast surgery (MIBS), encompassing endoscopic and robotic-assisted approaches, has emerged as one of the most significant innovations in contemporary breast surgical oncology. These techniques aim to address increasing patient expectations regarding body image and quality of life. Over the past decade, advancements in endoscopic visualization, robotic technology, reconstructive techniques, and surgeon experience have expanded the feasibility of minimally invasive nipple-sparing and skin-sparing mastectomy. Although several systematic reviews have demonstrated acceptable short-term oncologic and surgical outcomes, questions remain regarding patient selection, cost-effectiveness, training requirements, and long-term oncologic safety. This narrative review summarizes current indications, operative techniques, perioperative and oncologic outcomes, contemporary challenges, and future directions in minimally invasive breast surgery. Current evidence suggests that minimally invasive breast surgery is feasible and safe in carefully selected patients when performed by appropriately trained teams. Endoscopic approaches remain attractive because of lower costs and wider accessibility, whereas robotic platforms offer enhanced dexterity, visualization, and ergonomics. Future developments are likely to focus on standardization of techniques, structured training pathways, integration of advanced instrumentation, and generation of high-quality prospective evidence.