After the Neosphere trial: the realities of planning treatment. An audit of HER2 status availability for the initial diagnostic multi-disciplinary meetings in patients with newly diagnosed invasive breast cancers
Association of Breast Surgery ePoster Library. Brennan C. 05/13/19; 257120; P076
Christie Brennan
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Abstract
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P076
Topic: Diagnosis/ Referral
Following
the Neosphere trial1, women with HER2 positive invasive tumours ≥20mm
are being offered neo-adjuvant chemotherapy with dual anti-HER
treatment. HER2 status is crucial in determining sequence and extent of
therapy. New NICE guidelines2 recommend HER2 receptor status is
available at initial diagnostic multidisciplinary meetings, to avoid delays
in treatment. The availability of HER2 status at first MDT was audited to
assess if this occurs in practice.Locally approved retrospective audit of electronic records from new symptomatic or screen detected invasive
breast cancers, diagnosed between January and July 2018 at one district
hospital. HER2 testing completed at a neighbouring tertiary
centre.93 patients were diagnosed with invasive breast cancer in 7 months, 29 were referred from screening. 41 had radiological lesions ≥20mm (44%). The average time from biopsy to HER2 availability was 10.9 days (range 6-22). This increased for patients requiring
FISH (n=16) to 18.1days (range 6-24). There were 11 HER2
positive cases, 5 with tumours ≥20mm, none had HER2 status available for
initial MDT. Subsequently one patient proceeded to primary surgery, three
patients switched to NACT two days before scheduled surgery, one was palliative.Almost
half (44%) of patients were potentially suitable for dual neo-adjuvant therapy
at initial diagnosis. Subsequent delay in HER2 status means a
period of significant uncertainty for patients, and increased workloads for
clinicians, due to efforts to chase results in a timely manner, prolonged MDT
discussions of potential treatment pathways and repeated follow up
appointments. More work is required to examine optimisation of HER2 status
availability.
Topic: Diagnosis/ Referral
Following
the Neosphere trial1, women with HER2 positive invasive tumours ≥20mm
are being offered neo-adjuvant chemotherapy with dual anti-HER
treatment. HER2 status is crucial in determining sequence and extent of
therapy. New NICE guidelines2 recommend HER2 receptor status is
available at initial diagnostic multidisciplinary meetings, to avoid delays
in treatment. The availability of HER2 status at first MDT was audited to
assess if this occurs in practice.Locally approved retrospective audit of electronic records from new symptomatic or screen detected invasive
breast cancers, diagnosed between January and July 2018 at one district
hospital. HER2 testing completed at a neighbouring tertiary
centre.93 patients were diagnosed with invasive breast cancer in 7 months, 29 were referred from screening. 41 had radiological lesions ≥20mm (44%). The average time from biopsy to HER2 availability was 10.9 days (range 6-22). This increased for patients requiring
FISH (n=16) to 18.1days (range 6-24). There were 11 HER2
positive cases, 5 with tumours ≥20mm, none had HER2 status available for
initial MDT. Subsequently one patient proceeded to primary surgery, three
patients switched to NACT two days before scheduled surgery, one was palliative.Almost
half (44%) of patients were potentially suitable for dual neo-adjuvant therapy
at initial diagnosis. Subsequent delay in HER2 status means a
period of significant uncertainty for patients, and increased workloads for
clinicians, due to efforts to chase results in a timely manner, prolonged MDT
discussions of potential treatment pathways and repeated follow up
appointments. More work is required to examine optimisation of HER2 status
availability.
P076
Topic: Diagnosis/ Referral
Following
the Neosphere trial1, women with HER2 positive invasive tumours ≥20mm
are being offered neo-adjuvant chemotherapy with dual anti-HER
treatment. HER2 status is crucial in determining sequence and extent of
therapy. New NICE guidelines2 recommend HER2 receptor status is
available at initial diagnostic multidisciplinary meetings, to avoid delays
in treatment. The availability of HER2 status at first MDT was audited to
assess if this occurs in practice.Locally approved retrospective audit of electronic records from new symptomatic or screen detected invasive
breast cancers, diagnosed between January and July 2018 at one district
hospital. HER2 testing completed at a neighbouring tertiary
centre.93 patients were diagnosed with invasive breast cancer in 7 months, 29 were referred from screening. 41 had radiological lesions ≥20mm (44%). The average time from biopsy to HER2 availability was 10.9 days (range 6-22). This increased for patients requiring
FISH (n=16) to 18.1days (range 6-24). There were 11 HER2
positive cases, 5 with tumours ≥20mm, none had HER2 status available for
initial MDT. Subsequently one patient proceeded to primary surgery, three
patients switched to NACT two days before scheduled surgery, one was palliative.Almost
half (44%) of patients were potentially suitable for dual neo-adjuvant therapy
at initial diagnosis. Subsequent delay in HER2 status means a
period of significant uncertainty for patients, and increased workloads for
clinicians, due to efforts to chase results in a timely manner, prolonged MDT
discussions of potential treatment pathways and repeated follow up
appointments. More work is required to examine optimisation of HER2 status
availability.
Topic: Diagnosis/ Referral
Following
the Neosphere trial1, women with HER2 positive invasive tumours ≥20mm
are being offered neo-adjuvant chemotherapy with dual anti-HER
treatment. HER2 status is crucial in determining sequence and extent of
therapy. New NICE guidelines2 recommend HER2 receptor status is
available at initial diagnostic multidisciplinary meetings, to avoid delays
in treatment. The availability of HER2 status at first MDT was audited to
assess if this occurs in practice.Locally approved retrospective audit of electronic records from new symptomatic or screen detected invasive
breast cancers, diagnosed between January and July 2018 at one district
hospital. HER2 testing completed at a neighbouring tertiary
centre.93 patients were diagnosed with invasive breast cancer in 7 months, 29 were referred from screening. 41 had radiological lesions ≥20mm (44%). The average time from biopsy to HER2 availability was 10.9 days (range 6-22). This increased for patients requiring
FISH (n=16) to 18.1days (range 6-24). There were 11 HER2
positive cases, 5 with tumours ≥20mm, none had HER2 status available for
initial MDT. Subsequently one patient proceeded to primary surgery, three
patients switched to NACT two days before scheduled surgery, one was palliative.Almost
half (44%) of patients were potentially suitable for dual neo-adjuvant therapy
at initial diagnosis. Subsequent delay in HER2 status means a
period of significant uncertainty for patients, and increased workloads for
clinicians, due to efforts to chase results in a timely manner, prolonged MDT
discussions of potential treatment pathways and repeated follow up
appointments. More work is required to examine optimisation of HER2 status
availability.
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