Oncoplastic conservation for cT3 or multifocal / multicentric cancers (extreme oncoplasty) is oncologically safe
Association of Breast Surgery ePoster Library. Romics L. 05/13/19; 257155; P112
Mr. Laszlo Romics
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Abstract
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P112
Topic: Oncoplastic and aesthetic surgery
Introduction: cT3 breast cancers or multifocal / multicentric (MFMC) cancers are treated with mastectomy most commonly. However, oncoplastic techniques may allow breast conservation in selected patients, which is called extreme oncoplasty. The evidence for extreme oncoplasty is limited, hence we investigated this in our institutions. Methods Patients with cT3 or MFMC cancer on preoperative imaging were identified from a prospectively maintained oncoplastic database of two units in Glasgow. Demographic data, preoperative tumour parameters, operative techniques, post-operative pathology and follow up data were analyzed. Results: 292 consecutive patients were recorded in the database between June 2007 and March 2018. 49 patients with 50 breast cancers were treated with extreme oncoplasty. 28 patients had cT3 (median size: 55mm) and 21 had MFMC cancers. 45 patients were treated with volume displacement and 4 with volume replacement (3 LICAP, 1 TDAP). The median weight of excised specimen was 243 grams. 3 patients received neoadjuvant treatment with no response. 42 patients had invasive cancer, 7 had DCIS/LCIS. 32 patients were ER+, 5 were HER-2+, 13 were node+. 9 patients had incomplete margins (18.4%) (3 underwent re-excision, 6 had completion mastectomy). 23 patients received adjuvant chemotherapy and all received radiotherapy. During a median follow-up of 67 months (47 patients with a minimum follow-up of 1 year) no loco-regional recurrence was detected, two patients developed distant metastasis and two patients died. Conclusions: Extreme oncoplasty appears to be safe oncologically, although more patients with longer follow-up is required for better evidence.
Topic: Oncoplastic and aesthetic surgery
Introduction: cT3 breast cancers or multifocal / multicentric (MFMC) cancers are treated with mastectomy most commonly. However, oncoplastic techniques may allow breast conservation in selected patients, which is called extreme oncoplasty. The evidence for extreme oncoplasty is limited, hence we investigated this in our institutions. Methods Patients with cT3 or MFMC cancer on preoperative imaging were identified from a prospectively maintained oncoplastic database of two units in Glasgow. Demographic data, preoperative tumour parameters, operative techniques, post-operative pathology and follow up data were analyzed. Results: 292 consecutive patients were recorded in the database between June 2007 and March 2018. 49 patients with 50 breast cancers were treated with extreme oncoplasty. 28 patients had cT3 (median size: 55mm) and 21 had MFMC cancers. 45 patients were treated with volume displacement and 4 with volume replacement (3 LICAP, 1 TDAP). The median weight of excised specimen was 243 grams. 3 patients received neoadjuvant treatment with no response. 42 patients had invasive cancer, 7 had DCIS/LCIS. 32 patients were ER+, 5 were HER-2+, 13 were node+. 9 patients had incomplete margins (18.4%) (3 underwent re-excision, 6 had completion mastectomy). 23 patients received adjuvant chemotherapy and all received radiotherapy. During a median follow-up of 67 months (47 patients with a minimum follow-up of 1 year) no loco-regional recurrence was detected, two patients developed distant metastasis and two patients died. Conclusions: Extreme oncoplasty appears to be safe oncologically, although more patients with longer follow-up is required for better evidence.
P112
Topic: Oncoplastic and aesthetic surgery
Introduction: cT3 breast cancers or multifocal / multicentric (MFMC) cancers are treated with mastectomy most commonly. However, oncoplastic techniques may allow breast conservation in selected patients, which is called extreme oncoplasty. The evidence for extreme oncoplasty is limited, hence we investigated this in our institutions. Methods Patients with cT3 or MFMC cancer on preoperative imaging were identified from a prospectively maintained oncoplastic database of two units in Glasgow. Demographic data, preoperative tumour parameters, operative techniques, post-operative pathology and follow up data were analyzed. Results: 292 consecutive patients were recorded in the database between June 2007 and March 2018. 49 patients with 50 breast cancers were treated with extreme oncoplasty. 28 patients had cT3 (median size: 55mm) and 21 had MFMC cancers. 45 patients were treated with volume displacement and 4 with volume replacement (3 LICAP, 1 TDAP). The median weight of excised specimen was 243 grams. 3 patients received neoadjuvant treatment with no response. 42 patients had invasive cancer, 7 had DCIS/LCIS. 32 patients were ER+, 5 were HER-2+, 13 were node+. 9 patients had incomplete margins (18.4%) (3 underwent re-excision, 6 had completion mastectomy). 23 patients received adjuvant chemotherapy and all received radiotherapy. During a median follow-up of 67 months (47 patients with a minimum follow-up of 1 year) no loco-regional recurrence was detected, two patients developed distant metastasis and two patients died. Conclusions: Extreme oncoplasty appears to be safe oncologically, although more patients with longer follow-up is required for better evidence.
Topic: Oncoplastic and aesthetic surgery
Introduction: cT3 breast cancers or multifocal / multicentric (MFMC) cancers are treated with mastectomy most commonly. However, oncoplastic techniques may allow breast conservation in selected patients, which is called extreme oncoplasty. The evidence for extreme oncoplasty is limited, hence we investigated this in our institutions. Methods Patients with cT3 or MFMC cancer on preoperative imaging were identified from a prospectively maintained oncoplastic database of two units in Glasgow. Demographic data, preoperative tumour parameters, operative techniques, post-operative pathology and follow up data were analyzed. Results: 292 consecutive patients were recorded in the database between June 2007 and March 2018. 49 patients with 50 breast cancers were treated with extreme oncoplasty. 28 patients had cT3 (median size: 55mm) and 21 had MFMC cancers. 45 patients were treated with volume displacement and 4 with volume replacement (3 LICAP, 1 TDAP). The median weight of excised specimen was 243 grams. 3 patients received neoadjuvant treatment with no response. 42 patients had invasive cancer, 7 had DCIS/LCIS. 32 patients were ER+, 5 were HER-2+, 13 were node+. 9 patients had incomplete margins (18.4%) (3 underwent re-excision, 6 had completion mastectomy). 23 patients received adjuvant chemotherapy and all received radiotherapy. During a median follow-up of 67 months (47 patients with a minimum follow-up of 1 year) no loco-regional recurrence was detected, two patients developed distant metastasis and two patients died. Conclusions: Extreme oncoplasty appears to be safe oncologically, although more patients with longer follow-up is required for better evidence.
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