Neoadjuvant chemotherapy followed by immediate free tissue breast reconstruction: Audit of Post-Operative Outcomes in a Tertiary Centre
Association of Breast Surgery ePoster Library. McGoldrick C. 05/15/17; 166270; P007
Ms. Ciara McGoldrick
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Abstract
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Introduction: While neoadjuvant systemic therapy facilitates an increased rate of breast conserving surgery, some patients will require mastectomy and immediate autologous free flap reconstruction. Our institution has noted a 10-fold increase in the number of patients undergoing immediate autologous reconstruction following neoadjuvant chemotherapy since 2013.
Aim: To establish standards for post-operative outcomes against 2012 ABS/BAPRAS Oncoplastic Breast Reconstruction: Guidelines for Best Practice. In addition, outcomes for matched patients undergoing immediate reconstruction and standard adjuvant treatment and delayed reconstruction within our institution.
Method: Retrospective single centre audit 01/2013 – 08/2016. Inclusion criteria: Free flap breast reconstruction following neoadjuvant chemotherapy (NIR), standard therapy (IR)(mastectomy, immediate reconstruction and adjuvant chemo/radiotherapy) and delayed reconstruction (DR) (treatment completed 1 year prior). 19% of the neoadjuvant group had also received upfront radiotherapy.
Results : Chi squared p>0.05 No free flap loss in any group
Conclusion: Neoadjuvant chemotherapy followed by immediate free flap reconstruction carries acceptable levels of operative risk to both standard immediate and delayed reconstruction, whilst alleviating the time pressure to start adjuvant therapy. Strategies employed to optimise co-ordination of care in neoadjuvant patients in our institution are also discussed.
Aim: To establish standards for post-operative outcomes against 2012 ABS/BAPRAS Oncoplastic Breast Reconstruction: Guidelines for Best Practice. In addition, outcomes for matched patients undergoing immediate reconstruction and standard adjuvant treatment and delayed reconstruction within our institution.
Method: Retrospective single centre audit 01/2013 – 08/2016. Inclusion criteria: Free flap breast reconstruction following neoadjuvant chemotherapy (NIR), standard therapy (IR)(mastectomy, immediate reconstruction and adjuvant chemo/radiotherapy) and delayed reconstruction (DR) (treatment completed 1 year prior). 19% of the neoadjuvant group had also received upfront radiotherapy.
Results : Chi squared p>0.05 No free flap loss in any group
Conclusion: Neoadjuvant chemotherapy followed by immediate free flap reconstruction carries acceptable levels of operative risk to both standard immediate and delayed reconstruction, whilst alleviating the time pressure to start adjuvant therapy. Strategies employed to optimise co-ordination of care in neoadjuvant patients in our institution are also discussed.
Introduction: While neoadjuvant systemic therapy facilitates an increased rate of breast conserving surgery, some patients will require mastectomy and immediate autologous free flap reconstruction. Our institution has noted a 10-fold increase in the number of patients undergoing immediate autologous reconstruction following neoadjuvant chemotherapy since 2013.
Aim: To establish standards for post-operative outcomes against 2012 ABS/BAPRAS Oncoplastic Breast Reconstruction: Guidelines for Best Practice. In addition, outcomes for matched patients undergoing immediate reconstruction and standard adjuvant treatment and delayed reconstruction within our institution.
Method: Retrospective single centre audit 01/2013 – 08/2016. Inclusion criteria: Free flap breast reconstruction following neoadjuvant chemotherapy (NIR), standard therapy (IR)(mastectomy, immediate reconstruction and adjuvant chemo/radiotherapy) and delayed reconstruction (DR) (treatment completed 1 year prior). 19% of the neoadjuvant group had also received upfront radiotherapy.
Results : Chi squared p>0.05 No free flap loss in any group
Conclusion: Neoadjuvant chemotherapy followed by immediate free flap reconstruction carries acceptable levels of operative risk to both standard immediate and delayed reconstruction, whilst alleviating the time pressure to start adjuvant therapy. Strategies employed to optimise co-ordination of care in neoadjuvant patients in our institution are also discussed.
Aim: To establish standards for post-operative outcomes against 2012 ABS/BAPRAS Oncoplastic Breast Reconstruction: Guidelines for Best Practice. In addition, outcomes for matched patients undergoing immediate reconstruction and standard adjuvant treatment and delayed reconstruction within our institution.
Method: Retrospective single centre audit 01/2013 – 08/2016. Inclusion criteria: Free flap breast reconstruction following neoadjuvant chemotherapy (NIR), standard therapy (IR)(mastectomy, immediate reconstruction and adjuvant chemo/radiotherapy) and delayed reconstruction (DR) (treatment completed 1 year prior). 19% of the neoadjuvant group had also received upfront radiotherapy.
Results : Chi squared p>0.05 No free flap loss in any group
Conclusion: Neoadjuvant chemotherapy followed by immediate free flap reconstruction carries acceptable levels of operative risk to both standard immediate and delayed reconstruction, whilst alleviating the time pressure to start adjuvant therapy. Strategies employed to optimise co-ordination of care in neoadjuvant patients in our institution are also discussed.
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