Robotic surgical systems provide notable advantages including enhanced dexterity, a magnified three-dimensional high-definition view, and high-resolution imaging, thereby improving operative stability and precision. These features make robotic systems particularly suitable for procedures performed within confined operative spaces. As the breast is a solid organ without a natural cavity, robotic systems demonstrate strong adaptability for breast surgery. Robot-assisted breast-conserving surgery (RABCS) is one of the currently utilized robotic techniques in clinical breast cancer surgery. However, as robotic breast surgery remains in its early stage of development, evidence regarding the clinical outcomes of RABCS remains limited in the literature. Therefore, this study compares the surgical outcomes of endoscopic breast-conserving surgery and robot-assisted breast-conserving surgery in breast cancer patients, aiming to assess and elucidate the clinical value of RABCS.

Inclusion Criteria:

• Female patients aged 18 to 80 years
• Pathologically confirmed breast cancer prior to surgery
• Sufficient glandular volume with a tumor-to-breast volume ratio ≤20%
• A unifocal lesion confined to the glandular tissue
• Clear desire for breast conservation and willingness to undergo R-BCS or E-BCS
• No evidence of distant metastasis, no involvement of the skin or chest wall
• Eligibility for standard postoperative radiotherapy

Exclusion Criteria:

• The presence of diffuse suspicious lesions or microcalcifications for which wide local resection was unlikely to achieve adequate negative margins or satisfactory aesthetic outcomes
• Bilateral breast cancer or inflammatory breast cancer
• After neoadjuvant therapy, requirement for additional concurrent surgical procedures
• Inability to tolerate general anesthesia or undergo surgery
• Contraindications to radiotherapy or a history of prior chest wall irradiation, pregnancy- or lactation-associated breast cancer
• Refuse to undergo R-BCS or E-BCS