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190. Expression and circulating levels of perlecan in breast cancer
ABSTRACTS
S81
Results: Sixty-nine patients underwent reconstruction at BCH and sixteen at CAH. There was no significant difference in complications between BCH, CAH and NMBRA at 3 months (Table 1). There was no significant association between risk factors and rates of specific complications in the BCH group.
P
Immediate Reconstruction
Total Implant Pedicled flap + implant Pedicled flap Free flap Wound infection Implant loss Partial flap loss
adjuvant irradiation). The 5-year NED survival rates in BCS (tumor-free margin 1 cm) and BCS with irradiation (tumor-free margin <1 cm) groups were identical (83.3%). Conclusion: Our data supports the potential use of breast conserving surgery in patients with MPTB. Mastectomy is indicated only if tumor-
P
Delayed Reconstruction
NMBRA
BCH
CAH
NMBRA
BCH
CAH
1464 476 318 452 218 24.1% 8.9% 3.1%
52 22 7 23 0 21.1% 10.3% 0
13 8 2 3 0 7.7% 0 0
1731 93 167 164 236 26.8% 6.9% 4.9%
17 1 9 7 0 17.6% 10% 0
3 2 1 0 0 0 0 0
Conclusion: Quality outcomes at the regional teaching centre (BCH) and the district general hospital (CAH) were comparable. Complication rates recorded in both centres were in line with those reported in NMBRA. Limitations of our study include disparity in sample sizes and the retrospective nature of this audit. The case mix also differs from the NMBRA in that there are no free flap reconstructions in this series. Ongoing quality improvement studies are required to further develop the standard of care delivered to patients with breast cancer who are offered reconstruction. No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2014.08.183 189. Treatment options in patients with malignant phyllodes tumour of the breast J. Mitus1,5, M. Reinfuss2, J. Jakubowicz2, P. Blecharz3, W.M. Wysocki4, P. Skotnicki4 1 Cancer Centre Maria Sklodowska-Curie Institute of Oncology, Department of Surgical Oncology, Krakow, Poland 2 Centre of Oncology Maria Sklodowska-Curie Memorial Institute Krakow Branch Poland, Department of Radiotherapy, Krakow, Poland 3 Centre of Oncology Maria Sklodowska-Curie Memorial Institute Krakow Branch Poland, Department of Gynaecological Oncology, Krakow, Poland 4 Centre of Oncology Maria Sklodowska-Curie Memorial Institute Krakow Branch Poland, Department of Surgical Oncology, Krakow, Poland 5 Collegium Medicum Jagiellonian University, Department of Anatomy, Krakow, Poland Background: The primary treatment of choice in patients with malignant phyllodes tumor of the breast (MPTB) is surgical. However, the extent of surgery [breast conserving surgery (BCS) vs. mastectomy] and the role of adjuvant radiotherapy have been controversial. We report a single institution’s experience with MPTB. The aim of this work is to discuss therapeutic options of this rare tumor. Material and methods: From 1980 to 2008, seventy patients with MPTB treated primarily with surgery were evaluated. The age ranged from 21 to 76 years (mean 50) and the mean size of the tumor was 6 cm. In 34 (48.6%) patients total mastectomy was performed, and 36 (51.4%) patients were treated with BCS (lumpectomy or wide local excision). Microscopic surgical margins were free of tumor in all cases. In 64 (91.4%) patients, margins were 1 cm. In the remaining 6 (8.6%) patients treated with BCS margins were <1 cm and subsequently radiotherapy was performed. Results: In all 70 patients, 58 (82.9%) had no evidence of disease (NED) after 5 years. The 5-year NED survival rate was not significantly related to the extent of surgery (82.4% in patients who underwent mastectomy and 83.3% in patients who underwent BCS only or BCS with
0.74 0.74 1.0
0.58 0.5 1.0
free margins cannot be obtained by BCS. Adjuvant radiotherapy may be considered if tumor-free margins are <1 cm. No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2014.08.184
190. Expression and circulating levels of perlecan in breast cancer M. Jansson1, D. Ohlund2, M. Sund2 1 Dept of Surgery, Ume a, Sweden 2 Dept of Surgery, Ume a University, Ume a, Sweden Background: Breast cancer is the most common cancer and cause of cancer death among women. Localised breast cancer can be cured by surgery but the mortality remains high as some tumours metastasize early. Perlecan is a basal membrane protein, which is involved in promoting angiogenesis and invasiveness of cancers. Here, the expression pattern of Perlecan during tumour progression and related to the molecular subtypes of breast cancer (Luminal A, Luminal B, Luminal H, ErbB2 and Basal cell-like cancer) was studied. In addition, the pre- and postoperative circulating levels of Perlecan in plasma was measured in patients with breast cancer, and compared with controls. Methods: Perlecan expression in tissues was visualized using immunohistochemistry. Circulating levels of Perlecan was measured using an ELISA assay. The results were statistically analyzed by using one way ANOVA, independent t-test and the Kruskal-Wallis test. Results: As expected, in normal breast tissue Perlecan is expressed in both epithelial and vascular basal membranes and absent in the stroma. In breast cancer tissue the basal membrane is fragmented and sometimes completely disrupted. There is also a marked upregulation of Perlecan expression in the stroma. However, the Perlecan expression was not different between the molecular subtypes of breast cancer. The concentration of Perlecan in plasma was significantly higher in oestrogen receptor positive breast cancer compared with receptor negative breast cancer both in the pre- (p-value: 0,029) and the post-operative setting (p-value: 0,022). There was a borderline significance in Perlecan levels between the different subtypes of breast cancer (p-value: 0,097). Conclusion: Perlecan is expression becomes upregulated in the breast cancer stroma and seems to be related to hormone receptor positive breast cancer. In order to evaluate the prognostic impact for Perlecan expression in the tumour and whether Perlecan can be used as a tumour marker, larger cohorts with longer follow-ups are needed. No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2014.08.185
S81
Results: Sixty-nine patients underwent reconstruction at BCH and sixteen at CAH. There was no significant difference in complications between BCH, CAH and NMBRA at 3 months (Table 1). There was no significant association between risk factors and rates of specific complications in the BCH group.
P
Immediate Reconstruction
Total Implant Pedicled flap + implant Pedicled flap Free flap Wound infection Implant loss Partial flap loss
adjuvant irradiation). The 5-year NED survival rates in BCS (tumor-free margin 1 cm) and BCS with irradiation (tumor-free margin <1 cm) groups were identical (83.3%). Conclusion: Our data supports the potential use of breast conserving surgery in patients with MPTB. Mastectomy is indicated only if tumor-
P
Delayed Reconstruction
NMBRA
BCH
CAH
NMBRA
BCH
CAH
1464 476 318 452 218 24.1% 8.9% 3.1%
52 22 7 23 0 21.1% 10.3% 0
13 8 2 3 0 7.7% 0 0
1731 93 167 164 236 26.8% 6.9% 4.9%
17 1 9 7 0 17.6% 10% 0
3 2 1 0 0 0 0 0
Conclusion: Quality outcomes at the regional teaching centre (BCH) and the district general hospital (CAH) were comparable. Complication rates recorded in both centres were in line with those reported in NMBRA. Limitations of our study include disparity in sample sizes and the retrospective nature of this audit. The case mix also differs from the NMBRA in that there are no free flap reconstructions in this series. Ongoing quality improvement studies are required to further develop the standard of care delivered to patients with breast cancer who are offered reconstruction. No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2014.08.183 189. Treatment options in patients with malignant phyllodes tumour of the breast J. Mitus1,5, M. Reinfuss2, J. Jakubowicz2, P. Blecharz3, W.M. Wysocki4, P. Skotnicki4 1 Cancer Centre Maria Sklodowska-Curie Institute of Oncology, Department of Surgical Oncology, Krakow, Poland 2 Centre of Oncology Maria Sklodowska-Curie Memorial Institute Krakow Branch Poland, Department of Radiotherapy, Krakow, Poland 3 Centre of Oncology Maria Sklodowska-Curie Memorial Institute Krakow Branch Poland, Department of Gynaecological Oncology, Krakow, Poland 4 Centre of Oncology Maria Sklodowska-Curie Memorial Institute Krakow Branch Poland, Department of Surgical Oncology, Krakow, Poland 5 Collegium Medicum Jagiellonian University, Department of Anatomy, Krakow, Poland Background: The primary treatment of choice in patients with malignant phyllodes tumor of the breast (MPTB) is surgical. However, the extent of surgery [breast conserving surgery (BCS) vs. mastectomy] and the role of adjuvant radiotherapy have been controversial. We report a single institution’s experience with MPTB. The aim of this work is to discuss therapeutic options of this rare tumor. Material and methods: From 1980 to 2008, seventy patients with MPTB treated primarily with surgery were evaluated. The age ranged from 21 to 76 years (mean 50) and the mean size of the tumor was 6 cm. In 34 (48.6%) patients total mastectomy was performed, and 36 (51.4%) patients were treated with BCS (lumpectomy or wide local excision). Microscopic surgical margins were free of tumor in all cases. In 64 (91.4%) patients, margins were 1 cm. In the remaining 6 (8.6%) patients treated with BCS margins were <1 cm and subsequently radiotherapy was performed. Results: In all 70 patients, 58 (82.9%) had no evidence of disease (NED) after 5 years. The 5-year NED survival rate was not significantly related to the extent of surgery (82.4% in patients who underwent mastectomy and 83.3% in patients who underwent BCS only or BCS with
0.74 0.74 1.0
0.58 0.5 1.0
free margins cannot be obtained by BCS. Adjuvant radiotherapy may be considered if tumor-free margins are <1 cm. No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2014.08.184
190. Expression and circulating levels of perlecan in breast cancer M. Jansson1, D. Ohlund2, M. Sund2 1 Dept of Surgery, Ume a, Sweden 2 Dept of Surgery, Ume a University, Ume a, Sweden Background: Breast cancer is the most common cancer and cause of cancer death among women. Localised breast cancer can be cured by surgery but the mortality remains high as some tumours metastasize early. Perlecan is a basal membrane protein, which is involved in promoting angiogenesis and invasiveness of cancers. Here, the expression pattern of Perlecan during tumour progression and related to the molecular subtypes of breast cancer (Luminal A, Luminal B, Luminal H, ErbB2 and Basal cell-like cancer) was studied. In addition, the pre- and postoperative circulating levels of Perlecan in plasma was measured in patients with breast cancer, and compared with controls. Methods: Perlecan expression in tissues was visualized using immunohistochemistry. Circulating levels of Perlecan was measured using an ELISA assay. The results were statistically analyzed by using one way ANOVA, independent t-test and the Kruskal-Wallis test. Results: As expected, in normal breast tissue Perlecan is expressed in both epithelial and vascular basal membranes and absent in the stroma. In breast cancer tissue the basal membrane is fragmented and sometimes completely disrupted. There is also a marked upregulation of Perlecan expression in the stroma. However, the Perlecan expression was not different between the molecular subtypes of breast cancer. The concentration of Perlecan in plasma was significantly higher in oestrogen receptor positive breast cancer compared with receptor negative breast cancer both in the pre- (p-value: 0,029) and the post-operative setting (p-value: 0,022). There was a borderline significance in Perlecan levels between the different subtypes of breast cancer (p-value: 0,097). Conclusion: Perlecan is expression becomes upregulated in the breast cancer stroma and seems to be related to hormone receptor positive breast cancer. In order to evaluate the prognostic impact for Perlecan expression in the tumour and whether Perlecan can be used as a tumour marker, larger cohorts with longer follow-ups are needed. No conflict of interest. http://dx.doi.org/10.1016/j.ejso.2014.08.185