Partial breast reconstruction (PBR) with Lateral Chest Wall Perforator Flaps (CWPF) to facilitate breast conservation surgery (BCS) in women with breast cancer: A single center experience over 7 years and report on follow-up and patient reported outcomes.
Association of Breast Surgery ePoster Library. Mustata L. 05/13/19; 257153; P110
Ms. Laura Mustata
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Abstract
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P110
Topic: Oncoplastic and aesthetic surgery
Background: Lateral CWPF offers an excellent option for PBR in women undergoing BCS for laterally placed tumours in small to moderate non-ptotic breasts. Methods : A prospective database has been maintainedto collect information on clinicopathological features, complications and follow-up. Patients were asked to complete an anonymised PROM questionnaire. All patients are followed up annually for 5 years. Results: 105 patients underwent PBR with CWPF between 2011 and 2018. 75% patients underwent cancer resection and PBR as one operation whilst a quarter underwent PBR as two-stage approach. The two-stage approach was undertaken for patients with high tumour to breast ratio (expected loss of breast volume of 30% or more), in an attempt to avoid mastectomy.The median tumour size on pre-op imaging was 30 mm. 48% women in this cohort had chemotherapy and 12% were Her-2 positive. The complication rate was low and re-operation rate for inadequate margins was under 10%. The median follow-up is 39 months (range: 12 months to 7 years) with no local recurrence reported so far; 3 patients presented with distant disease. The presence of flap did not interfere with interpretation of surveillance mammogram in our cohort. PROM states high satisfaction scores in majority of the domains.Conclusion: BCS with PBR provides an effective oncological approach with good cosmesis, as judged by patients.We recommend considering two-stage approach in women with high tumour-breast ratio to ensure successful BCS prior to undertaking PBR. The medium term follow-up data establishes the safety of BCS in women with high-risk tumour characteristics.
Topic: Oncoplastic and aesthetic surgery
Background: Lateral CWPF offers an excellent option for PBR in women undergoing BCS for laterally placed tumours in small to moderate non-ptotic breasts. Methods : A prospective database has been maintainedto collect information on clinicopathological features, complications and follow-up. Patients were asked to complete an anonymised PROM questionnaire. All patients are followed up annually for 5 years. Results: 105 patients underwent PBR with CWPF between 2011 and 2018. 75% patients underwent cancer resection and PBR as one operation whilst a quarter underwent PBR as two-stage approach. The two-stage approach was undertaken for patients with high tumour to breast ratio (expected loss of breast volume of 30% or more), in an attempt to avoid mastectomy.The median tumour size on pre-op imaging was 30 mm. 48% women in this cohort had chemotherapy and 12% were Her-2 positive. The complication rate was low and re-operation rate for inadequate margins was under 10%. The median follow-up is 39 months (range: 12 months to 7 years) with no local recurrence reported so far; 3 patients presented with distant disease. The presence of flap did not interfere with interpretation of surveillance mammogram in our cohort. PROM states high satisfaction scores in majority of the domains.Conclusion: BCS with PBR provides an effective oncological approach with good cosmesis, as judged by patients.We recommend considering two-stage approach in women with high tumour-breast ratio to ensure successful BCS prior to undertaking PBR. The medium term follow-up data establishes the safety of BCS in women with high-risk tumour characteristics.
P110
Topic: Oncoplastic and aesthetic surgery
Background: Lateral CWPF offers an excellent option for PBR in women undergoing BCS for laterally placed tumours in small to moderate non-ptotic breasts. Methods : A prospective database has been maintainedto collect information on clinicopathological features, complications and follow-up. Patients were asked to complete an anonymised PROM questionnaire. All patients are followed up annually for 5 years. Results: 105 patients underwent PBR with CWPF between 2011 and 2018. 75% patients underwent cancer resection and PBR as one operation whilst a quarter underwent PBR as two-stage approach. The two-stage approach was undertaken for patients with high tumour to breast ratio (expected loss of breast volume of 30% or more), in an attempt to avoid mastectomy.The median tumour size on pre-op imaging was 30 mm. 48% women in this cohort had chemotherapy and 12% were Her-2 positive. The complication rate was low and re-operation rate for inadequate margins was under 10%. The median follow-up is 39 months (range: 12 months to 7 years) with no local recurrence reported so far; 3 patients presented with distant disease. The presence of flap did not interfere with interpretation of surveillance mammogram in our cohort. PROM states high satisfaction scores in majority of the domains.Conclusion: BCS with PBR provides an effective oncological approach with good cosmesis, as judged by patients.We recommend considering two-stage approach in women with high tumour-breast ratio to ensure successful BCS prior to undertaking PBR. The medium term follow-up data establishes the safety of BCS in women with high-risk tumour characteristics.
Topic: Oncoplastic and aesthetic surgery
Background: Lateral CWPF offers an excellent option for PBR in women undergoing BCS for laterally placed tumours in small to moderate non-ptotic breasts. Methods : A prospective database has been maintainedto collect information on clinicopathological features, complications and follow-up. Patients were asked to complete an anonymised PROM questionnaire. All patients are followed up annually for 5 years. Results: 105 patients underwent PBR with CWPF between 2011 and 2018. 75% patients underwent cancer resection and PBR as one operation whilst a quarter underwent PBR as two-stage approach. The two-stage approach was undertaken for patients with high tumour to breast ratio (expected loss of breast volume of 30% or more), in an attempt to avoid mastectomy.The median tumour size on pre-op imaging was 30 mm. 48% women in this cohort had chemotherapy and 12% were Her-2 positive. The complication rate was low and re-operation rate for inadequate margins was under 10%. The median follow-up is 39 months (range: 12 months to 7 years) with no local recurrence reported so far; 3 patients presented with distant disease. The presence of flap did not interfere with interpretation of surveillance mammogram in our cohort. PROM states high satisfaction scores in majority of the domains.Conclusion: BCS with PBR provides an effective oncological approach with good cosmesis, as judged by patients.We recommend considering two-stage approach in women with high tumour-breast ratio to ensure successful BCS prior to undertaking PBR. The medium term follow-up data establishes the safety of BCS in women with high-risk tumour characteristics.
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