How does the Multi Disciplinary Team use systemic neo-adjuvant chemotherapy & does it facilitate Breast Conserving Surgery in a symptomatic practice?
Association of Breast Surgery ePoster Library. McKenna C. 05/15/17; 166191; P087
Dr. Christine Marie McKenna
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Abstract
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Introduction:
The use of Systemic Neo-Adjuvant Chemotherapy (NAC) to facilitate Breast Conserving Surgery(BCS) has evolved in recent years. We aim to show our Multi-Disciplinary Team(MDT) uses NAC to facilitate all form of breast resection, including safe breast conservation, in a diverse symptomatic population.
Methods:
Retrospective cohort of all our symptomatic breast cancer patients undergoing systemic NAC between 2010 -2015; Clinical notes and oncology letters were reviewed until last follow-up or death. Chi-Squared and Student T-test statistics were used.
Results:
74 women, mean age of 48yrs, underwent NAC. 7/74 had Luminal-A phenotype, 31/74 Luminal-B, 21/74 HER2+ & 15/74 Triple-negative. MDT indications for NAC included; 'facilitating BCS'(29/74), 'down-staging Inflammatory cancer'(12/74), ' making the chest wall operable'(14/74), 'general high-risk disease'(12/74) & for 'heavy axillary burden'(7/74). Within the BCS group 21/29(72%) achieved BCS. 3/21(14%) patients required a second procedure to achieve clear margins. No patient having BCS had local recurrence, mean follow-up 27months. In those with heavy axillary burden, all went on to ANC with no local recurrence, mean follow-up 22months. Patients needing NAC to make the chest wall operable all underwent resection with clear margins, 4/14(29%) relapsed within 9months. NAC for general 'High-risk' disease featured higher proportions of HER2+/Triple-Negative tumour phenotypes, 4/12(33%) recurred with mean time of 4months.
Conclusions:
Our MDT recommends NAC for varied indications, most commonly to facilitate BCS. A large proportion of patients achieve BCS with low risk of needing further procedures and no local recurrences. Other indications have variable outcomes despite multimodal therapy, due to underlying aggressive tumour biology.
The use of Systemic Neo-Adjuvant Chemotherapy (NAC) to facilitate Breast Conserving Surgery(BCS) has evolved in recent years. We aim to show our Multi-Disciplinary Team(MDT) uses NAC to facilitate all form of breast resection, including safe breast conservation, in a diverse symptomatic population.
Methods:
Retrospective cohort of all our symptomatic breast cancer patients undergoing systemic NAC between 2010 -2015; Clinical notes and oncology letters were reviewed until last follow-up or death. Chi-Squared and Student T-test statistics were used.
Results:
74 women, mean age of 48yrs, underwent NAC. 7/74 had Luminal-A phenotype, 31/74 Luminal-B, 21/74 HER2+ & 15/74 Triple-negative. MDT indications for NAC included; 'facilitating BCS'(29/74), 'down-staging Inflammatory cancer'(12/74), ' making the chest wall operable'(14/74), 'general high-risk disease'(12/74) & for 'heavy axillary burden'(7/74). Within the BCS group 21/29(72%) achieved BCS. 3/21(14%) patients required a second procedure to achieve clear margins. No patient having BCS had local recurrence, mean follow-up 27months. In those with heavy axillary burden, all went on to ANC with no local recurrence, mean follow-up 22months. Patients needing NAC to make the chest wall operable all underwent resection with clear margins, 4/14(29%) relapsed within 9months. NAC for general 'High-risk' disease featured higher proportions of HER2+/Triple-Negative tumour phenotypes, 4/12(33%) recurred with mean time of 4months.
Conclusions:
Our MDT recommends NAC for varied indications, most commonly to facilitate BCS. A large proportion of patients achieve BCS with low risk of needing further procedures and no local recurrences. Other indications have variable outcomes despite multimodal therapy, due to underlying aggressive tumour biology.
Introduction:
The use of Systemic Neo-Adjuvant Chemotherapy (NAC) to facilitate Breast Conserving Surgery(BCS) has evolved in recent years. We aim to show our Multi-Disciplinary Team(MDT) uses NAC to facilitate all form of breast resection, including safe breast conservation, in a diverse symptomatic population.
Methods:
Retrospective cohort of all our symptomatic breast cancer patients undergoing systemic NAC between 2010 -2015; Clinical notes and oncology letters were reviewed until last follow-up or death. Chi-Squared and Student T-test statistics were used.
Results:
74 women, mean age of 48yrs, underwent NAC. 7/74 had Luminal-A phenotype, 31/74 Luminal-B, 21/74 HER2+ & 15/74 Triple-negative. MDT indications for NAC included; 'facilitating BCS'(29/74), 'down-staging Inflammatory cancer'(12/74), ' making the chest wall operable'(14/74), 'general high-risk disease'(12/74) & for 'heavy axillary burden'(7/74). Within the BCS group 21/29(72%) achieved BCS. 3/21(14%) patients required a second procedure to achieve clear margins. No patient having BCS had local recurrence, mean follow-up 27months. In those with heavy axillary burden, all went on to ANC with no local recurrence, mean follow-up 22months. Patients needing NAC to make the chest wall operable all underwent resection with clear margins, 4/14(29%) relapsed within 9months. NAC for general 'High-risk' disease featured higher proportions of HER2+/Triple-Negative tumour phenotypes, 4/12(33%) recurred with mean time of 4months.
Conclusions:
Our MDT recommends NAC for varied indications, most commonly to facilitate BCS. A large proportion of patients achieve BCS with low risk of needing further procedures and no local recurrences. Other indications have variable outcomes despite multimodal therapy, due to underlying aggressive tumour biology.
The use of Systemic Neo-Adjuvant Chemotherapy (NAC) to facilitate Breast Conserving Surgery(BCS) has evolved in recent years. We aim to show our Multi-Disciplinary Team(MDT) uses NAC to facilitate all form of breast resection, including safe breast conservation, in a diverse symptomatic population.
Methods:
Retrospective cohort of all our symptomatic breast cancer patients undergoing systemic NAC between 2010 -2015; Clinical notes and oncology letters were reviewed until last follow-up or death. Chi-Squared and Student T-test statistics were used.
Results:
74 women, mean age of 48yrs, underwent NAC. 7/74 had Luminal-A phenotype, 31/74 Luminal-B, 21/74 HER2+ & 15/74 Triple-negative. MDT indications for NAC included; 'facilitating BCS'(29/74), 'down-staging Inflammatory cancer'(12/74), ' making the chest wall operable'(14/74), 'general high-risk disease'(12/74) & for 'heavy axillary burden'(7/74). Within the BCS group 21/29(72%) achieved BCS. 3/21(14%) patients required a second procedure to achieve clear margins. No patient having BCS had local recurrence, mean follow-up 27months. In those with heavy axillary burden, all went on to ANC with no local recurrence, mean follow-up 22months. Patients needing NAC to make the chest wall operable all underwent resection with clear margins, 4/14(29%) relapsed within 9months. NAC for general 'High-risk' disease featured higher proportions of HER2+/Triple-Negative tumour phenotypes, 4/12(33%) recurred with mean time of 4months.
Conclusions:
Our MDT recommends NAC for varied indications, most commonly to facilitate BCS. A large proportion of patients achieve BCS with low risk of needing further procedures and no local recurrences. Other indications have variable outcomes despite multimodal therapy, due to underlying aggressive tumour biology.
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