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P090. Breast cancer awareness in young women – A national survey 2014
S52 A small number of patients develop large areas of fat necrosis after breast conservation surgery and radiotherapy resulting in deformity and pain. No recognised treatment exists. The aim of the study was to evaluate the efficacy of liposuction and fat transfer in the treatment of breast oedema and fat necrosis. Methods: Eight patients underwent liposuction and/or fat transfer for breast oedema, morphea and/or fat necrosis. Their records were reviewed retrospectively. Results: Two patients developed significant oedema, erythema and pain after surgery compounded by the effect of radiotherapy. Both had an estimated 30% increase in breast volume. A third patient developed major oedema, pain and breast shrinkage in the year following breast conservation and radiotherapy. Five patients developed significant areas of fat necrosis following breast conservation (with or without therapeutic mammaplasty) and radiotherapy. These patients underwent 1e4 episodes of liposuction and fat grafting. All experienced a reduction in breast pain. Photographs show resolution of distortion, erythema and oedema in all patients. Symmetry was achieved in all but two patients who had undergone contralateral symmetrisation procedures. Conclusion: Liposuction and fat transfer (grafting) is effective in patients with significant morbidity due to breast oedema and fat necrosis.
ABSTRACTS published literature comparing the clinical and patient-reported outcomes (PROs) of these different techniques. Methods: Ovid SP versions of EMBASE and MEDLINE databases were used to identify all studies which met the inclusion criteria published between January 1995 and December 2013. Key words used were “breast”, “reconstruct”, “immediate,” “outcome”, “satisfaction”, “PROMs”,” Patient reported outcomes”, “complications”. Two authors performed the search and extracted data separately. Results: The search yielded a total of 12 articles. 7/12 compared clinical outcomes between the two techniques and 5/12 compared PROs. All of the clinical outcome papers were retrospective single-centre case series. 4/ 7 found a significant difference in clinical outcomes of which 3/4 reported worse outcomes in the implant based group. The 5 studies which compared PROs were heterogenous in terms of the method used for comparative assessment. Of these 5 studies, 2/5 showed no significant difference between the two groups, 2/5 showed improved outcomes in the autologous group and 1/5 showed equivalent outcomes apart from two domains (role functioning and pain) which were worse in the autologous group. Conclusions: There is insufficient high quality evidence in the literature to enable an objective comparison to be made between the outcomes of the different types of immediate breast reconstruction techniques. http://dx.doi.org/10.1016/j.ejso.2015.03.129
http://dx.doi.org/10.1016/j.ejso.2015.03.127
P090. Breast cancer awareness in young women e A national survey 2014 Rachel Wilson North Middlesex University Hospital, London, UK Aims: CoppaFeel! is a charity improving breast cancer awareness in young women. With funding from the charity, a national survey of young women’s perceptions of breast cancer was conducted. It looked at attitudes to the risk of developing breast cancer, knowledge of the symptoms, the degree of self-checking for signs of breast cancer and the perceived barriers to accessing medical advice. Finally, we assessed the impact of breast awareness charities. Methods: Between 27th June and 9th July 2014, 1337 women were randomly surveyed online nationwide. The questionnaire consisted of 43 questions and was carried out by Vision Critical, an independent market research company. Inclusion criteria were women aged 18e30 years with a mix of working status and social class. 328 (25%) were students where CoppaFeel! has on site university presence. Results: In summary, 22% felt there was a chance of developing breast cancer in their lifetimes. 58% felt confident recognising the signs and symptoms of breast cancer yet 68% had never checked their breasts. 39% felt the biggest barrier to accessing medical advice was concern over wasting the doctor’s time. 26% reported being prompted to self-check by television programmes, 9% by charities and 8% by doctors. Conclusions: Despite being the most common cancer diagnosed in women under 40, a vast proportion of young women have a poor understanding of breast cancer, its signs and symptoms, how to check their breasts and when to seek medical advice. CoppaFeel! was founded for these reasons and continues to educate and empower young women.
P092. Outcomes of immediate breast reconstruction using an implant and acellular dermal matrix: A systematic review of the different products currently in use Lorna Cook, Michael Douek Kings College London, London, UK Introduction: Over the last 10e15 years there has been a significant increase in acellular dermal matrix (ADM) use for breast reconstruction, which has lead to the introduction of multiple alternative ADM products. We conducted a systematic review of studies reporting on the outcomes of ADMs currently used for immediate implant-based breast reconstruction. Methods: Ovid SP versions of EMBASE and MEDLINE databases were used. Search terms were: ((“breast” OR “breast reconstruction”) AND (“acellular dermal matrix” OR “acellular dermis” OR Strattice OR Surgimend OR Alloderm OR Human acellular dermis OR cadaveric dermis or acellular dermis-assisted or Dermamatrix or FlexHD or Neoform)). Strict inclusion and exclusion criteria were applied, data was abstracted using a pro forma and risk of bias was assessed using the Down’s and Black checklist. Results: A total of 27 studies met inclusion criteria. 18/27 were retrospective case series and 9/27 were cohort studies with a non-ADM control group. There were no randomised controlled trials. There were 2 studies on bovine ADM use and 6 on porcine ADM use, with the remainder reporting on human ADMs. Significant risk of bias was demonstrated in the cohort studies, mainly as a result of allocation bias and a lack of information related to the distribution of potential confounders. Conclusions: There remains very little high quality evidence for the outcomes of breast reconstruction using an ADM, particularly for non-human ADMs. High risk of bias means individual study results cannot reliably be combined in the form of a meta-analysis.
http://dx.doi.org/10.1016/j.ejso.2015.03.128 http://dx.doi.org/10.1016/j.ejso.2015.03.130 P091. Outcomes of immediate breast reconstruction using different techniques: A systematic review of comparative studies Lorna Cook, Michaela Massa, Michael Douek Kings College London, London, UK Introduction: The choice of procedure for immediate breast reconstruction is mainly between autologous or implant-based techniques, with many women suitable for both. We systematically reviewed all
P093. Modified periareolar mammaplasty (MPM) for wide local excision of breast cancers in the upper half of the breast Sukitha Namal Rupasinghe, Bincy Jacob, Karen James, Raman Vinayagam Wirral Breast Unit, Clatterbridge Hospital, Wirral University Teaching Hospital NHS Foundation Trust, Bebington, Merseyside, UK
ABSTRACTS published literature comparing the clinical and patient-reported outcomes (PROs) of these different techniques. Methods: Ovid SP versions of EMBASE and MEDLINE databases were used to identify all studies which met the inclusion criteria published between January 1995 and December 2013. Key words used were “breast”, “reconstruct”, “immediate,” “outcome”, “satisfaction”, “PROMs”,” Patient reported outcomes”, “complications”. Two authors performed the search and extracted data separately. Results: The search yielded a total of 12 articles. 7/12 compared clinical outcomes between the two techniques and 5/12 compared PROs. All of the clinical outcome papers were retrospective single-centre case series. 4/ 7 found a significant difference in clinical outcomes of which 3/4 reported worse outcomes in the implant based group. The 5 studies which compared PROs were heterogenous in terms of the method used for comparative assessment. Of these 5 studies, 2/5 showed no significant difference between the two groups, 2/5 showed improved outcomes in the autologous group and 1/5 showed equivalent outcomes apart from two domains (role functioning and pain) which were worse in the autologous group. Conclusions: There is insufficient high quality evidence in the literature to enable an objective comparison to be made between the outcomes of the different types of immediate breast reconstruction techniques. http://dx.doi.org/10.1016/j.ejso.2015.03.129
http://dx.doi.org/10.1016/j.ejso.2015.03.127
P090. Breast cancer awareness in young women e A national survey 2014 Rachel Wilson North Middlesex University Hospital, London, UK Aims: CoppaFeel! is a charity improving breast cancer awareness in young women. With funding from the charity, a national survey of young women’s perceptions of breast cancer was conducted. It looked at attitudes to the risk of developing breast cancer, knowledge of the symptoms, the degree of self-checking for signs of breast cancer and the perceived barriers to accessing medical advice. Finally, we assessed the impact of breast awareness charities. Methods: Between 27th June and 9th July 2014, 1337 women were randomly surveyed online nationwide. The questionnaire consisted of 43 questions and was carried out by Vision Critical, an independent market research company. Inclusion criteria were women aged 18e30 years with a mix of working status and social class. 328 (25%) were students where CoppaFeel! has on site university presence. Results: In summary, 22% felt there was a chance of developing breast cancer in their lifetimes. 58% felt confident recognising the signs and symptoms of breast cancer yet 68% had never checked their breasts. 39% felt the biggest barrier to accessing medical advice was concern over wasting the doctor’s time. 26% reported being prompted to self-check by television programmes, 9% by charities and 8% by doctors. Conclusions: Despite being the most common cancer diagnosed in women under 40, a vast proportion of young women have a poor understanding of breast cancer, its signs and symptoms, how to check their breasts and when to seek medical advice. CoppaFeel! was founded for these reasons and continues to educate and empower young women.
P092. Outcomes of immediate breast reconstruction using an implant and acellular dermal matrix: A systematic review of the different products currently in use Lorna Cook, Michael Douek Kings College London, London, UK Introduction: Over the last 10e15 years there has been a significant increase in acellular dermal matrix (ADM) use for breast reconstruction, which has lead to the introduction of multiple alternative ADM products. We conducted a systematic review of studies reporting on the outcomes of ADMs currently used for immediate implant-based breast reconstruction. Methods: Ovid SP versions of EMBASE and MEDLINE databases were used. Search terms were: ((“breast” OR “breast reconstruction”) AND (“acellular dermal matrix” OR “acellular dermis” OR Strattice OR Surgimend OR Alloderm OR Human acellular dermis OR cadaveric dermis or acellular dermis-assisted or Dermamatrix or FlexHD or Neoform)). Strict inclusion and exclusion criteria were applied, data was abstracted using a pro forma and risk of bias was assessed using the Down’s and Black checklist. Results: A total of 27 studies met inclusion criteria. 18/27 were retrospective case series and 9/27 were cohort studies with a non-ADM control group. There were no randomised controlled trials. There were 2 studies on bovine ADM use and 6 on porcine ADM use, with the remainder reporting on human ADMs. Significant risk of bias was demonstrated in the cohort studies, mainly as a result of allocation bias and a lack of information related to the distribution of potential confounders. Conclusions: There remains very little high quality evidence for the outcomes of breast reconstruction using an ADM, particularly for non-human ADMs. High risk of bias means individual study results cannot reliably be combined in the form of a meta-analysis.
http://dx.doi.org/10.1016/j.ejso.2015.03.128 http://dx.doi.org/10.1016/j.ejso.2015.03.130 P091. Outcomes of immediate breast reconstruction using different techniques: A systematic review of comparative studies Lorna Cook, Michaela Massa, Michael Douek Kings College London, London, UK Introduction: The choice of procedure for immediate breast reconstruction is mainly between autologous or implant-based techniques, with many women suitable for both. We systematically reviewed all
P093. Modified periareolar mammaplasty (MPM) for wide local excision of breast cancers in the upper half of the breast Sukitha Namal Rupasinghe, Bincy Jacob, Karen James, Raman Vinayagam Wirral Breast Unit, Clatterbridge Hospital, Wirral University Teaching Hospital NHS Foundation Trust, Bebington, Merseyside, UK