ABS ePoster Library

Introduction: latest research suggests breast conserving surgery (BCS) with radiotherapy is as safe as mastectomy, with cosmetic and psychological advantages. Patient preference is sometimes the reason given for variability in mastectomy rates; we wanted to review regionally how many patients eligible for BCS were choosing mastectomy.
Methods: a retrospective electronic hospital records review of all mastectomy procedures performed in Gloucestershire from October 2015 to March 2016 was undertaken. The unit manages circa 650 cancers per year, offering reconstructive and onco-plastic surgery. Demographics and indication for proceeding with mastectomy were identified.
Results: 80 patients underwent mastectomy in six months: 26 for proportionality of disease relative to breast-size (Within this group: 2 males (BCS unfeasible), 11 downsizing of DCIS / diffuse nodular invasive lobular carcinoma not possible, 6 inadequate response to neoadjuvant chemotherapy / hormone therapy for BCS); 7 completion after failed BCS (4 patients had ≥2 re-excisions)); 13 for recurrent disease in an irradiated breast; 19 for multicentric disease; 8 for risk-reduction; 1 where radiotherapy following BCS contraindicated due to pulmonary fibrosis ; 6 for patient preference (1 had a previous contralateral mastectomy, 2 chose mastectomy despite successful neoadjuvant downstaging chemotherapy, 1 to simplify treatment due to co-morbidities).
Conclusions: mastectomy was chosen for non-medical reasons by six patients; few patients eligible for BCS opt for mastectomy. The message that BCS is as safe as mastectomy may be getting through; efforts to further reduce mastectomy rates may be limited by the current available treatments for early and locally advanced breast cancer.