Extreme oncoplastic conservation is a safe new alternative to mastectomy
Association of Breast Surgery ePoster Library. Pearce B. 05/13/19; 257151; P108
Ms. Belinda Pearce
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Abstract
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P108
Topic: Oncoplastic and aesthetic surgery
AimsExtreme oncoplastic breast conserving surgery (eOPBCS) allows breast conservation for tumours ≤50mm, but long-term outcomes are unclear. We investigated early complications and the longer-term clinical and oncological outcomes following eOPBCS to assess it's clinical utility and safety. Methods A prospectively collected database of all eOPBCS procedures (1993-2016) using LD miniflaps (MF) and therapeutic mammoplasties (TM) was interrogated and cross-checked with hospital records to establish length of follow up (FU), clinical outcomes (complications, revisions), local recurrence (LR) and survival. Results: Ninety eOPBCS procedures (62 MF, 28 TM) performed for large tumours (mean 67 [50-177] mm) were identified, overall FU 80 (10-308) months (MF 91 [13-308], TM 54 [10-120] months). Forty two per cent were node +, 2 were benign and excluded from LR and FU analysis. Eleven patients required surgery for positive margins (MF 3 re-excisions / 2 mastectomies, TM 6 mastectomies). Surgery for complications (e.g. delayed healing, infection, haematoma) and subsequent revision (e.g. fat transfer, nipple reconstruction) was required in 6% and 37% of MF patients and in 18% and 7% of TM patients, respectively. Seven LRs were recorded (MF 5 versusTM 2), LR rate 1.2% PA [MF 1.1% versusTM 1.7%], mortality rate 2.1% PA).ConclusionLong-term FU of this unique series confirms that eOPBCS provides a safe alternative to mastectomy +/- reconstruction for patients with bulky tumours, without risking local control. TM patients have more early complications but MF patients require more revisions with more prolonged FU.
Topic: Oncoplastic and aesthetic surgery
AimsExtreme oncoplastic breast conserving surgery (eOPBCS) allows breast conservation for tumours ≤50mm, but long-term outcomes are unclear. We investigated early complications and the longer-term clinical and oncological outcomes following eOPBCS to assess it's clinical utility and safety. Methods A prospectively collected database of all eOPBCS procedures (1993-2016) using LD miniflaps (MF) and therapeutic mammoplasties (TM) was interrogated and cross-checked with hospital records to establish length of follow up (FU), clinical outcomes (complications, revisions), local recurrence (LR) and survival. Results: Ninety eOPBCS procedures (62 MF, 28 TM) performed for large tumours (mean 67 [50-177] mm) were identified, overall FU 80 (10-308) months (MF 91 [13-308], TM 54 [10-120] months). Forty two per cent were node +, 2 were benign and excluded from LR and FU analysis. Eleven patients required surgery for positive margins (MF 3 re-excisions / 2 mastectomies, TM 6 mastectomies). Surgery for complications (e.g. delayed healing, infection, haematoma) and subsequent revision (e.g. fat transfer, nipple reconstruction) was required in 6% and 37% of MF patients and in 18% and 7% of TM patients, respectively. Seven LRs were recorded (MF 5 versusTM 2), LR rate 1.2% PA [MF 1.1% versusTM 1.7%], mortality rate 2.1% PA).ConclusionLong-term FU of this unique series confirms that eOPBCS provides a safe alternative to mastectomy +/- reconstruction for patients with bulky tumours, without risking local control. TM patients have more early complications but MF patients require more revisions with more prolonged FU.
P108
Topic: Oncoplastic and aesthetic surgery
AimsExtreme oncoplastic breast conserving surgery (eOPBCS) allows breast conservation for tumours ≤50mm, but long-term outcomes are unclear. We investigated early complications and the longer-term clinical and oncological outcomes following eOPBCS to assess it's clinical utility and safety. Methods A prospectively collected database of all eOPBCS procedures (1993-2016) using LD miniflaps (MF) and therapeutic mammoplasties (TM) was interrogated and cross-checked with hospital records to establish length of follow up (FU), clinical outcomes (complications, revisions), local recurrence (LR) and survival. Results: Ninety eOPBCS procedures (62 MF, 28 TM) performed for large tumours (mean 67 [50-177] mm) were identified, overall FU 80 (10-308) months (MF 91 [13-308], TM 54 [10-120] months). Forty two per cent were node +, 2 were benign and excluded from LR and FU analysis. Eleven patients required surgery for positive margins (MF 3 re-excisions / 2 mastectomies, TM 6 mastectomies). Surgery for complications (e.g. delayed healing, infection, haematoma) and subsequent revision (e.g. fat transfer, nipple reconstruction) was required in 6% and 37% of MF patients and in 18% and 7% of TM patients, respectively. Seven LRs were recorded (MF 5 versusTM 2), LR rate 1.2% PA [MF 1.1% versusTM 1.7%], mortality rate 2.1% PA).ConclusionLong-term FU of this unique series confirms that eOPBCS provides a safe alternative to mastectomy +/- reconstruction for patients with bulky tumours, without risking local control. TM patients have more early complications but MF patients require more revisions with more prolonged FU.
Topic: Oncoplastic and aesthetic surgery
AimsExtreme oncoplastic breast conserving surgery (eOPBCS) allows breast conservation for tumours ≤50mm, but long-term outcomes are unclear. We investigated early complications and the longer-term clinical and oncological outcomes following eOPBCS to assess it's clinical utility and safety. Methods A prospectively collected database of all eOPBCS procedures (1993-2016) using LD miniflaps (MF) and therapeutic mammoplasties (TM) was interrogated and cross-checked with hospital records to establish length of follow up (FU), clinical outcomes (complications, revisions), local recurrence (LR) and survival. Results: Ninety eOPBCS procedures (62 MF, 28 TM) performed for large tumours (mean 67 [50-177] mm) were identified, overall FU 80 (10-308) months (MF 91 [13-308], TM 54 [10-120] months). Forty two per cent were node +, 2 were benign and excluded from LR and FU analysis. Eleven patients required surgery for positive margins (MF 3 re-excisions / 2 mastectomies, TM 6 mastectomies). Surgery for complications (e.g. delayed healing, infection, haematoma) and subsequent revision (e.g. fat transfer, nipple reconstruction) was required in 6% and 37% of MF patients and in 18% and 7% of TM patients, respectively. Seven LRs were recorded (MF 5 versusTM 2), LR rate 1.2% PA [MF 1.1% versusTM 1.7%], mortality rate 2.1% PA).ConclusionLong-term FU of this unique series confirms that eOPBCS provides a safe alternative to mastectomy +/- reconstruction for patients with bulky tumours, without risking local control. TM patients have more early complications but MF patients require more revisions with more prolonged FU.
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