Abstract
<title>Abstract</title> <p>Background Conventional nipple-sparing mastectomy (C-NSM) is an important surgical method for breast cancer, but minimal access nipple-sparing mastectomy (M-NSM) have now emerged as a cutting-edge focus within breast surgery. However, there remains a scarcity of comprehensive studies evaluating the overall advantages and limitations of minimally invasive breast surgery. Materials and Methods A comprehensive literature search was conducted across four major databases (PubMed, Embase, Web of Science, Cochrane Library) from their inception to August,7,2025. Studies comparing the efficacy of M-NSM and C-NSM in patients with breast cancer were included.The meta-analysis evaluated multiple clinical outcomes, including operative time, length of hospital stay, blood loss, total complication, specific complications, recurrence, metastasis, patient satisfaction and medical cost. Results A total of 20 studies involving 5908 patients were included. M-NSM exhibited statistically significant advantages over C-NSM in terms of recurrence and distant metastasis rate. Furthermore, M-NSM showed superior outcomes in overall complications, incision length, seroma formation, skin necrosis, and had higher patient satisfaction.Blood loss in the M-NSM group was lower than that observed in the C-NSM group with no significant difference. However, M-NSM was associated with longer operative and hospitalization durations, including total mastectomy with implant reconstruction time, mastectomy time, and hospital stays.Additionally, the medical costs associated with M-NSM were significantly higher than those for C-NSM.No statistically significant differences were observed between the two groups in terms of infection, NAC necrosis, hematoma, wound dehiscence, implant loss, and capsular contracture. Conclusion M-NSM represents a valuable surgical option that enhances oncological safety and operative feasibility for breast cancer.</p>