An Audit of the Management of Breast Cancer in Women Aged Less Than 40 Against BCY3 Guidelines in a Tertiary Breast Unit.
Association of Breast Surgery ePoster Library. Heard R. 05/13/19; 257181; P139
Rachel Heard
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P139
Topic: Other
Introduction: The 3rd International Consensus Conference for Breast Cancer in Young Women(BCY3) issued guidelines (November 2016) for the management of women under 40 years old. We audited our practice against these standards. Methods :Ladies diagnosed with breast cancer aged under 40, during 2016, were identified from MDT records. Data on management were obtained retrospectively from electronic and paper records. Management was audited against BCY3 guidelines. Results: In 2016,49 patients at our unit were diagnosed with breast cancer under the age of 40 (age range 22-39 years).At diagnosis, clinical findings were often subtle, with 64% (25/ 39 with a documented P score) being either P1 or P2. Routine MRI is not advocated in BCY3 guidelines but MRI was performed preoperatively in 55% of women (27/49), of whom 11 (41%) were found to have a larger tumour/ multifocal disease not identified on other imaging modalities. 53% (26/49) had neoadjuvant chemotherapy (18 ER-ve; 8 ER>3 of these 6/8 were HER2+ve).Local guidelines for genetics and fertility counselling differ from BCY3, therefore the standard that all women should be referred to both services was not met. 63% of ladies underwent mastectomy (31/49) with a high-proportion (35% 11/31) electing not to have immediate reconstruction following documented discussion. Conclusions: Management of young-women with breast cancer generally adhered to BCY3 guidelines. Clinical findings were often subtle and pre-operative MRI led to the detection of more multifocal / larger tumours than standard imaging modalities, and should be considered if pre-op uncertainty over sizing.
Topic: Other
Introduction: The 3rd International Consensus Conference for Breast Cancer in Young Women(BCY3) issued guidelines (November 2016) for the management of women under 40 years old. We audited our practice against these standards. Methods :Ladies diagnosed with breast cancer aged under 40, during 2016, were identified from MDT records. Data on management were obtained retrospectively from electronic and paper records. Management was audited against BCY3 guidelines. Results: In 2016,49 patients at our unit were diagnosed with breast cancer under the age of 40 (age range 22-39 years).At diagnosis, clinical findings were often subtle, with 64% (25/ 39 with a documented P score) being either P1 or P2. Routine MRI is not advocated in BCY3 guidelines but MRI was performed preoperatively in 55% of women (27/49), of whom 11 (41%) were found to have a larger tumour/ multifocal disease not identified on other imaging modalities. 53% (26/49) had neoadjuvant chemotherapy (18 ER-ve; 8 ER>3 of these 6/8 were HER2+ve).Local guidelines for genetics and fertility counselling differ from BCY3, therefore the standard that all women should be referred to both services was not met. 63% of ladies underwent mastectomy (31/49) with a high-proportion (35% 11/31) electing not to have immediate reconstruction following documented discussion. Conclusions: Management of young-women with breast cancer generally adhered to BCY3 guidelines. Clinical findings were often subtle and pre-operative MRI led to the detection of more multifocal / larger tumours than standard imaging modalities, and should be considered if pre-op uncertainty over sizing.
P139
Topic: Other
Introduction: The 3rd International Consensus Conference for Breast Cancer in Young Women(BCY3) issued guidelines (November 2016) for the management of women under 40 years old. We audited our practice against these standards. Methods :Ladies diagnosed with breast cancer aged under 40, during 2016, were identified from MDT records. Data on management were obtained retrospectively from electronic and paper records. Management was audited against BCY3 guidelines. Results: In 2016,49 patients at our unit were diagnosed with breast cancer under the age of 40 (age range 22-39 years).At diagnosis, clinical findings were often subtle, with 64% (25/ 39 with a documented P score) being either P1 or P2. Routine MRI is not advocated in BCY3 guidelines but MRI was performed preoperatively in 55% of women (27/49), of whom 11 (41%) were found to have a larger tumour/ multifocal disease not identified on other imaging modalities. 53% (26/49) had neoadjuvant chemotherapy (18 ER-ve; 8 ER>3 of these 6/8 were HER2+ve).Local guidelines for genetics and fertility counselling differ from BCY3, therefore the standard that all women should be referred to both services was not met. 63% of ladies underwent mastectomy (31/49) with a high-proportion (35% 11/31) electing not to have immediate reconstruction following documented discussion. Conclusions: Management of young-women with breast cancer generally adhered to BCY3 guidelines. Clinical findings were often subtle and pre-operative MRI led to the detection of more multifocal / larger tumours than standard imaging modalities, and should be considered if pre-op uncertainty over sizing.
Topic: Other
Introduction: The 3rd International Consensus Conference for Breast Cancer in Young Women(BCY3) issued guidelines (November 2016) for the management of women under 40 years old. We audited our practice against these standards. Methods :Ladies diagnosed with breast cancer aged under 40, during 2016, were identified from MDT records. Data on management were obtained retrospectively from electronic and paper records. Management was audited against BCY3 guidelines. Results: In 2016,49 patients at our unit were diagnosed with breast cancer under the age of 40 (age range 22-39 years).At diagnosis, clinical findings were often subtle, with 64% (25/ 39 with a documented P score) being either P1 or P2. Routine MRI is not advocated in BCY3 guidelines but MRI was performed preoperatively in 55% of women (27/49), of whom 11 (41%) were found to have a larger tumour/ multifocal disease not identified on other imaging modalities. 53% (26/49) had neoadjuvant chemotherapy (18 ER-ve; 8 ER>3 of these 6/8 were HER2+ve).Local guidelines for genetics and fertility counselling differ from BCY3, therefore the standard that all women should be referred to both services was not met. 63% of ladies underwent mastectomy (31/49) with a high-proportion (35% 11/31) electing not to have immediate reconstruction following documented discussion. Conclusions: Management of young-women with breast cancer generally adhered to BCY3 guidelines. Clinical findings were often subtle and pre-operative MRI led to the detection of more multifocal / larger tumours than standard imaging modalities, and should be considered if pre-op uncertainty over sizing.
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