大多数情况下，早期乳腺癌患者采用经腋单孔内窥镜保存乳头乳晕切除术并行即刻植入乳房重建术（E-NSM-IIBR），既确保手术安全，又实现提高乳房美学效果。然而，E-NSM-IIBR 是否适用于接受新辅助化疗（NAC）的患者仍不清楚。本研究旨在比较接受 NAC 的乳腺癌患者与未接受 NAC 的乳腺癌患者接受E-NSM-IIBR的手术安全性和患者报告的结果（PROs）。我们在2021年1月至2022年7月期间的单个中心对接受或不接受NAC的 E-NSM-IIBR 患者进行了回顾性队列研究。比较了两组患者的人口统计学资料、术后并发症和使用BREAST-Q 2.0问卷评估的PROs。使用线性回归分析评估了手术后9个月的PROs相关因素。 共纳入92例接受E-NSM-IIBR的患者，其中27例接受了NAC，65例未接受NAC。两组之间的术后并发症发生率没有显著差异。NAC组中27例患者中有24例（88.9%）完成了9个月术后的BREAST-Q 2.0问卷，非NAC组中65例患者中有59例（90.8%）完成了问卷。BREAST-Q在各个领域的患者报告的结果在两组之间没有显著差异。多元线性回归分析结果显示，两组患者的年龄（NAC组 β = -0.985，95% CI -1.598 to -0.371，p = 0.003；非NAC组 β = -0.510，-1.011 to -0.009，p = 0.046）和皮下纹理（NAC组 β = -21.862，-36.768 to -6.955，p = 0.006；非NAC组 β = -7.787，-15.151 to -0.423，p = 0.039）显著影响乳房满意度，NAC后接受放射治疗（PMRT）与患者胸部身体健康相关（NAC组 β = -13.813，-26.962 to -0.664，p = 0.040；非NAC组 β = -18.574，-30.661 to -6.487，p = 0.003）。我们的研究结果显示，较大的植入物体积与患者的心理社交福祉得分显著相关（β = 0.082，0.001 to 0.162，p = 0.047），而植入物位移与非NAC组的患者心理福祉有负面影响（β = -14.937，-28.175 to -1.700，p = 0.028）。然而，在NAC组内，我们的结果没有显示出任何显著影响患者心理社交福祉的因素。 我们的初步经验表明，即使在接受NAC后，E-NSM-IIBR对于选择的患者仍然是一个安全的选择，其患者报告的结果与原始手术相当。未来需要进一步研究接受NAC后放射治疗的患者的术后长期效果。 本期刊要求作者为每篇文章分配一个证据级别。有关这些循证医学评级的详细说明，请参阅目录或在线作者指南 www.springer.com/00266. © 2023 Springer Science+Business Media, LLC, Springer Nature 和国际美容整形医学学会的一部分。

In most cases, transaxillary single-port endoscopic nipple-sparing mastectomy with immediate implant-based breast reconstruction (E-NSM-IIBR) is conducted in patients with early-stage breast cancer, ensuring surgical safety while achieving improved breast aesthetics. However, whether E-NSM-IIBR is appropriate in patients undergoing neoadjuvant chemotherapy (NAC) is still unclear. The aim of this study was to report the surgical safety and patient-reported outcomes (PROs) of breast cancer patients who underwent E-NSM-IIBR with NAC in comparison to those who did not receive NAC.A retrospective cohort study was conducted on patients who underwent E-NSM-IIBR with or without NAC at a single center between January 2021 and July 2022. Patient demographics, postoperative complications, and PROs evaluated using the BREAST-Q version 2.0 questionnaire were compared between the two groups. Factors associated with PROs at 9 months after surgery were assessed with linear regression analysis.A total of 92 patients who underwent E-NSM-IIBR were included in the study, with 27 patients receiving NAC and 65 patients not receiving NAC. There was no significant difference in the incidence of postoperative complications between the two groups. The BREAST-Q version 2.0 questionnaire was completed by 24 out of 27 patients (88.9%) in the NAC group and 59 out of 65 patients (90.8%) in the non-NAC group at 9 months after surgery. The patient-reported outcomes in various domains of the BREAST-Q did not show a significant difference between the two cohorts. The results of the multiple linear regression analysis indicated that in the both groups age (β = - 0.985, 95% CI - 1.598 to - 0.371, p = 0.003 in the NAC group; β = - 0.510, - 1.011 to - 0.009, p = 0.046 in the non-NAC group) and rippling (β = - 21.862, - 36.768 to - 6.955, p = 0.006 in the NAC group; β = - 7.787, - 15.151 to - 0.423, p = 0.039 in the non-NAC group) significantly impacted the patients' satisfaction with breasts, and PMRT was negatively associated with patients' physical well-being of chest (β = - 13.813, - 26.962 to - 0.664, p = 0.040 in the NAC group; β = - 18.574, - 30.661 to - 6.487, p = 0.003 in the non-NAC group). Our findings revealed that patients with larger implant volumes had higher scores in psychosocial well-being (β = 0.082, 0.001 to 0.162, p = 0.047), whereas implant displacement (β = - 14.937, - 28.175 to - 1.700, p=0.028) had a negative impact on patients' psychological well-being in the non-NAC group. However, our results did not demonstrate any significant influencing factors on patients' psychosocial well-being within the NAC group.Our preliminary experiences confirm that E-NSM-IIBR is a safe option for selected patients even after NAC, with favorable patient-reported outcomes comparable with those in the primary surgery setting. The postoperative long-term outcomes of patients who undergo radiation therapy after NAC merit further investigation in the future.This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .© 2023. Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery.