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To identify the breast cancer specific survival (BCSS) associated with nodal metastasis identified by axillary core biopsy (ACB), and by sentinel node biopsy (SNB) compared with node negative patients. A further aim was to assess the prognostic effects of axillary ultrasound (US) features and amount of tumour in ACB specimens. Consecutive patients with cancer were identified from a database of US lesions undergoing breast biopsy. The three study groups were: a) those with metastasis identified by ACB, b) those undergoing immediate surgery with positive SNB and c) those undergoing immediate surgery with a negative SNB. US features and the amount of tumour in the ACB specimen were assessed by review of US images and pathological reports. BCSS was assessed using Kaplan Meier survival curves. 967 patients were included, with mean follow-up of 6.0 yrs. There were 90 breast cancer deaths: 26% of those with a positive ACB, 11% with a positive SNB and 4% of those with a negative SNB. BCSS was significantly different between the groups (p < 0.001) with hazard ratio, compared with the negative SNB group, of 7.8 (95% CI 4.4–13.7) for patients with positive ACB and 2.5 (95% CI 1.3–4.6) for positive SNB. Axillary US findings and assessment of the amount of tumour in the ACB did not influence survival. This study suggests that women with a positive ACB have a worse BCSS compared to those with a positive SNB. This should be borne in mind when systemic therapy is being considered. [ABSTRACT FROM AUTHOR]

Introduction Current evidence for oncoplastic breast conservation (OBC) is based on single institutional series. Therefore, we carried out a population-based audit of OBC practice and outcomes in Scotland. Methods A predefined database of patients treated with OBC was completed retrospectively in all breast units practicing OBC in Scotland. Results 589 patients were included from 11 units. Patients were diagnosed between September 2005 and March 2017. High volume units performed a mean of 19.3 OBCs per year vs. low volume units who did 11.1 (p = 0.012). 23 different surgical techniques were used. High volume units offered a wider range of techniques (8–14) than low volume units (3–6) (p = 0.004). OBC was carried out as a joint operation involving a breast and a plastic surgeon in 389 patients. Immediate contralateral symmetrisation rate was significantly higher when OBC was performed as a joint operation (70.7% vs. not joint operations: 29.8%; p < 0.001). The incomplete excision rate was 10.4% and was significantly higher after surgery for invasive lobular carcinoma (18.9%; p = 0.0292), but was significantly lower after neoadjuvant chemotherapy (3%; p = 0.031). 9.2% of patients developed major complications requiring hospital admission. Overall the complication rate was significantly lower after neoadjuvant chemotherapy (p = 0.035). The 5 year local recurrence rate was 2.7%, which was higher after OBC for DCIS (8.3%) than invasive ductal cancer (1.6%; p = 0.026). 5-year disease-free survival was 91.7%, overall survival was 93.8%, and cancer-specific survival was 96.1%. Conclusion This study demonstrated that measured outcomes of OBC in a population-based multi-centre setting can be comparable to the outcomes of large volume single centre series. [ABSTRACT FROM AUTHOR]

Purpose Debate continues on what is an adequate margin width to define a clear margin and whether there is a need to excise pectoral fascia or remove skin in breast conserving surgery. This study set out to provide answers to these questions. Patients and methods 1411 patients with invasive breast cancer were treated by breast conserving surgery and post-operative whole breast radiotherapy from January 2000 to December 2005. Distance from each margin to any in situ or invasive cancer was measured and recorded. If full thickness of breast tissue was removed no re excision of anterior and posterior margins was performed even if disease was <1 mm from a margin. Patients ≤50 years of age and those with anterior or posterior margins <1 mm to invasive cancer had a radiation boost. Median follow-up time was 6.4 years. Results Local in breast tumour relapse (IBTR) occurred in 50 patients. The overall actuarial IBTR rate at 5 years was 2.2%. There was no difference in IBTR when comparing patients with radial margins of 1–5 mm or 5–10 mm. Anterior and posterior margins <1 mm or with ink on tumour cells were not associated with an increase in IBTR. Conclusion There is no justification for radial margins of greater than 1 mm. If the anterior or posterior margin is <1 mm and full thickness of breast tissue has been removed, then re excision of these margins is unnecessary if boost radiotherapy is delivered. [ABSTRACT FROM AUTHOR]

B Background: b Multiple feasibility studies have confirmed high sensitivity of indocyanine green (ICG) fluorescence mapping for sentinel node detection in early breast cancer. B Materials and Methods: b All consecutive patients undergoing sentinel node biopsy (SNB) for early breast cancer in NHS Tayside were included in a prospective audit of surgical and pathology findings. B Results: b Data was available for 50 consecutive female patients in whom 52 cases were performed due to bilateral disease, with a mean age of 61 years (range 33-87), with 44 patients undergoing primary SNB, 6 patients having 4 node SNB post chemotherapy, and 2 having repeat SNB for failed SNB (n=1) and previous ipsilateral cancer SNB (n=1). [Extracted from the article]

Abstract: Background: Sentinel node biopsy as a surgical method of axillary staging for early breast cancer has been widely accepted as an alternative to traditional four-node axillary node sampling, and is the recommended technique by the Association of Breast Surgery in the United Kingdom. In selected units axillary sampling has been compared with either radioisotope sentinel node or blue dye only techniques with comparable node positivity rates. There are no studies directly comparing combined method sentinel node biopsy (SNB) with conventional axillary (four) node sampling (ANS). Methods: Data for all patients undergoing axillary staging by axillary node sample or sentinel node biopsy were collected, including those proceeding to axillary clearance as a second procedure, but excluding those undergoing axillary clearance as a first procedure. Results: From January 2005 to January 2011, 641 axillary staging procedures were performed (SNB n =231 (36.0%), ANS n =410 (64.0%)). Baseline tumour characteristics were similar for the two groups except for a higher frequency of breast conservation in the SNB group (95.6 vs. 75.6%; p <0.0001). The proportion of cases with positive nodes was higher in the SNB group (20.8 vs. 14.4%; p =0.042). In patients who had presented with symptomatic disease, there was a significantly higher node positivity rate with SNB (30.9%) than with ANS (15.5%; p =0.002), despite similar baseline characteristics in both groups. Conclusion: Combined method sentinel node biopsy is more sensitive at detecting low volume axillary disease than traditional four-node sample. [Copyright &y& Elsevier]

Abstract: Background: Complete tumour excision in breast conserving surgery (BCS) is critical for successful outcome; involved circumferential resection margins are associated with increased disease recurrence. However, the importance of an involved anterior margin (IAM) is less clear. The purpose of this study was to review an aggressive approach to IAM and hence assess whether anterior margin re-excision (RE) yields clinical benefit. Methods: A review of prospectively collected clinical and pathology data was performed for all patients who underwent BCS between 2006 and 2010 through a single cancer centre. An involved margin was defined as <1 mm clearance of invasive or in-situ breast cancer. Results: 1667 patients underwent BCS for invasive and/or in-situ disease, of whom 114 underwent RE. A total of 170 involved margins were identified: most commonly the anterior (52 margins) followed by the posterior (39 margins) and inferior (31 margins) margin. Patients with IAM were more likely to have grade 3 invasive disease (p = 0.0323) but less likely to have residual disease found at re-excision (2/49 vs. 32/101 margins, p = 0.0033); there were no differences when in-situ characteristics were compared. Conclusions: RE of IAM after BCS rarely yields further disease; multi-disciplinary teams should consider whether further therapy for an IAM is required on a patient by patient basis. [Copyright &y& Elsevier]

Patient reported outcomes before and after bilateral therapeutic mammoplasty for breast cancer: A prospective audit. P143. [Extracted from the article]

Indocyanine green as an alternative to radioisotope in breast cancer sentinel node biopsy: A single centre experience during COVID 19 hospital site relocation. P010. [Extracted from the article]

B Background: b Sentinel node biopsy is the most commonly used procedure for staging of the axilla in early breast cancer. B Materials and Methods: b Consecutive patients who had undergone sentinel node biopsy for early breast cancer within our cancer centre were given an anonymised questionnaire with visual analogue scale to complete regarding symptoms in the postoperative period. [Extracted from the article]