Neo-Adjuvant Chemotherapy In A Semi-Rural District General Hospital: Why Not?
Association of Breast Surgery ePoster Library. Gomez K. 05/13/19; 257109; P065
Kelvin Gomez
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P065
Topic: Breast surgery
Introduction: Neo-adjuvant chemotherapy (NAC) is a treatment modality used to downsize breast cancers. Its effectiveness is also a useful prognostic indicator for risk of recurrence. The aim of our study was to ascertain if this was achievable in a District General Hospital located in a semi-rural setting. Methods This was a retrospective review of the clinical data from all breast cancer patients undergoing NAC at Nevill Hall Hospital from January 2013-December 2017. Multiple datasets were produced and statistical analysis was performed using SPSS version 21.0. A p-value of < 0.05 was considered significant. Results: There were 70 patients in our cohort, with a median age at diagnosis of 49 years and a median follow-up of 36 months. Breast conservation surgery (BCS) was performed in 29 patients (41.4%). Within this group undergoing BCS, 16 patients (55.1%) were meant to undergo mastectomies at the time of diagnosis. The median tumour size was 35mm at diagnosis and 16.5mm at final histology. Pathological complete response (PCR) was achieved in 18 patients (25.7%). 55% of patients achieving PCR had HER-2 positive disease (p=0.03). Of the 39 patients with node positive disease at initial diagnosis, 14 (35.8%) were node negative at final surgery. Recurrence and mortality rates were 12.9% and 8.6% respectively at a median duration of 21 months from diagnosis. Conclusions: Our data show that with the correct elements in place, especially a robust MDT process, undertaking NAC in a semi-rural setting is achievable, to the benefit of all relevant patients.
Topic: Breast surgery
Introduction: Neo-adjuvant chemotherapy (NAC) is a treatment modality used to downsize breast cancers. Its effectiveness is also a useful prognostic indicator for risk of recurrence. The aim of our study was to ascertain if this was achievable in a District General Hospital located in a semi-rural setting. Methods This was a retrospective review of the clinical data from all breast cancer patients undergoing NAC at Nevill Hall Hospital from January 2013-December 2017. Multiple datasets were produced and statistical analysis was performed using SPSS version 21.0. A p-value of < 0.05 was considered significant. Results: There were 70 patients in our cohort, with a median age at diagnosis of 49 years and a median follow-up of 36 months. Breast conservation surgery (BCS) was performed in 29 patients (41.4%). Within this group undergoing BCS, 16 patients (55.1%) were meant to undergo mastectomies at the time of diagnosis. The median tumour size was 35mm at diagnosis and 16.5mm at final histology. Pathological complete response (PCR) was achieved in 18 patients (25.7%). 55% of patients achieving PCR had HER-2 positive disease (p=0.03). Of the 39 patients with node positive disease at initial diagnosis, 14 (35.8%) were node negative at final surgery. Recurrence and mortality rates were 12.9% and 8.6% respectively at a median duration of 21 months from diagnosis. Conclusions: Our data show that with the correct elements in place, especially a robust MDT process, undertaking NAC in a semi-rural setting is achievable, to the benefit of all relevant patients.
P065
Topic: Breast surgery
Introduction: Neo-adjuvant chemotherapy (NAC) is a treatment modality used to downsize breast cancers. Its effectiveness is also a useful prognostic indicator for risk of recurrence. The aim of our study was to ascertain if this was achievable in a District General Hospital located in a semi-rural setting. Methods This was a retrospective review of the clinical data from all breast cancer patients undergoing NAC at Nevill Hall Hospital from January 2013-December 2017. Multiple datasets were produced and statistical analysis was performed using SPSS version 21.0. A p-value of < 0.05 was considered significant. Results: There were 70 patients in our cohort, with a median age at diagnosis of 49 years and a median follow-up of 36 months. Breast conservation surgery (BCS) was performed in 29 patients (41.4%). Within this group undergoing BCS, 16 patients (55.1%) were meant to undergo mastectomies at the time of diagnosis. The median tumour size was 35mm at diagnosis and 16.5mm at final histology. Pathological complete response (PCR) was achieved in 18 patients (25.7%). 55% of patients achieving PCR had HER-2 positive disease (p=0.03). Of the 39 patients with node positive disease at initial diagnosis, 14 (35.8%) were node negative at final surgery. Recurrence and mortality rates were 12.9% and 8.6% respectively at a median duration of 21 months from diagnosis. Conclusions: Our data show that with the correct elements in place, especially a robust MDT process, undertaking NAC in a semi-rural setting is achievable, to the benefit of all relevant patients.
Topic: Breast surgery
Introduction: Neo-adjuvant chemotherapy (NAC) is a treatment modality used to downsize breast cancers. Its effectiveness is also a useful prognostic indicator for risk of recurrence. The aim of our study was to ascertain if this was achievable in a District General Hospital located in a semi-rural setting. Methods This was a retrospective review of the clinical data from all breast cancer patients undergoing NAC at Nevill Hall Hospital from January 2013-December 2017. Multiple datasets were produced and statistical analysis was performed using SPSS version 21.0. A p-value of < 0.05 was considered significant. Results: There were 70 patients in our cohort, with a median age at diagnosis of 49 years and a median follow-up of 36 months. Breast conservation surgery (BCS) was performed in 29 patients (41.4%). Within this group undergoing BCS, 16 patients (55.1%) were meant to undergo mastectomies at the time of diagnosis. The median tumour size was 35mm at diagnosis and 16.5mm at final histology. Pathological complete response (PCR) was achieved in 18 patients (25.7%). 55% of patients achieving PCR had HER-2 positive disease (p=0.03). Of the 39 patients with node positive disease at initial diagnosis, 14 (35.8%) were node negative at final surgery. Recurrence and mortality rates were 12.9% and 8.6% respectively at a median duration of 21 months from diagnosis. Conclusions: Our data show that with the correct elements in place, especially a robust MDT process, undertaking NAC in a semi-rural setting is achievable, to the benefit of all relevant patients.
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