Abstract PS1-61: Clinical and patient reported outcomes in oncoplastic breast conservation surgery from a single surgeon's practice in a busy community hospital in Canada

Abstract

Introduction: Oncoplastic breast surgery combines oncologic partial mastectomy with ipsilateral defect repair using volume displacement and volume replacement techniques with contralateral symmetrising surgery as appropriate. Oncoplastic surgery aims to maintain quality of life by pre-empting and mitigating against breast asymmetry whilst not compromising oncological effectiveness. Although growing in popularity in North America, many patients still do not have access to these techniques which usually involve longer operation times and require a surgeon with specialized oncoplastic training. This study demonstrates the implementation of an effective oncoplastic surgical practice in a community hospital within Canada and shows low rates of peri-operative complications as well as high levels of patient-reported outcome measures. Methods:A retrospective chart review of consecutive patients diagnosed with Stage 0-3 breast cancer treated with level I and level II oncoplastic techniques by a single breast surgeon was undertaken. Patient demographics, tumor characteristics, procedure types, and clinical outcomes were collected. Patient satisfaction was assessed with the Breast-Q questionnaire administered pre-operatively as well as 3 months and 9 months post-operatively. Results:Oncoplastic breast conservation surgery was performed in 340 patients over a 31 month period from 2017-2019. The average size of breast lesion was 1.8 cm with 96 patients having lesions 2-5 cm in size, and 10 patients having tumours >5cm. Thirty (8.8%) patients experienced a complication requiring intervention. Margin revisions were required in 21.8% of patients which reduced to 18% after the implementation of the new margin consensus guidelines. The completion mastectomy rate was 4.7%. Contralateral symmetrizing procedures were performed in 31 (9.1%) of patients by the surgeon performing the patient's breast conservation surgery. Breast Q scores increased across breast satisfaction, process of care, psychosocial, physical, and sexual satisfaction domains post-operatively. Conclusion:This study demonstrates the feasibility of an oncoplastic breast surgery practice in a busy community hospital in Canada. This adds to the growing body of North American data on the clinical and oncological safety of these techniques and introduces the idea of collecting patient-reported outcome measures within a Canadian population. We hope that this will serve to aid in the recruitment of oncoplastic-trained surgeons to both teaching and community hospitals and enable these techniques to become the standard of care in North America. Citation Format: Ashley DiPasquale, Zofia Prus-Czarnecka, Lindsay Delmar, Lashan Peiris. Clinical and patient reported outcomes in oncoplastic breast conservation surgery from a single surgeon's practice in a busy community hospital in Canada [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-61.