breast cancer awareness month: is it a waste of time?

1
P116. Day case mastectomy: Feasibility, length of hospital stay and patient satisfaction Sekhar Marla, Christopher McEvoy, Amtul Carmichael Russells Hall Hospital, Dudley, UK Introduction: Increasing breast-conserving surgery and less axillary surgery (sentinel node biopsy) have lead to a significant reduction in average length of hospital stay (LOS). Over 30 percent of patients undergo mastectomies and recent studies have shown day case/ one night stay to be a safe approach. Having made changes to the surgical pathways for all breast cancer patients, we assessed the LOS and feasibility of day case mastectomy at our hospital. Methods: All mastectomies with or without an axillary procedure per- formed over the past 2 years were included. Patient demographics, type of surgery, LOS and patient satisfaction (using a modified Quality of Recov- ery-40 postal questionnaire) were assessed. Patients who underwent imme- diate reconstruction were excluded. Results: From January 2012 to November 2013, 217 women under- went mastectomy. Median age was 71 (36-93) years. 85% (n¼185) under- went surgery as day case/one night stay. 10% (n¼21) were discharged the same day. Patient satisfaction results are awaited. Conclusions: With changes in the surgical pathway, majority of mas- tectomy patients can be managed as day case/ one night stay irrespective of axillary procedure performed. Results of patient satisfaction survey would advise improvements in the pathway. http://dx.doi.org/10.1016/j.ejso.2014.02.116 P117. Breast cancer awareness month: Is it a waste of time? Asad Parvaiz, Virginia Summerour, Brian Isgar New Cross Hospital, Wolverhampton, UK Introduction: Breast cancer awareness month (BCAM) is an annual international health campaign every October to increase awareness of the disease. We aimed to assess breast cancer risk awareness amongst hos- pital staff with relevance to BCAM. Methods: A short questionnaire of fifteen possible risk factors for breast cancer was given to the hospital staff nurses. They were asked to recognise these risk factors as yes/ no/ do not know. The survey was carried out in two phases; phase 1 was Pre-BCAM, in the month of September and the phase 2 was Post-BCAM, in the month of November. Results: A total of 73 hospital staff nurses were surveyed; 34 in September 2012 and 39 in November 2012. A 100% response rate was observed. Median correct response rate was 50% in Sep and 46% in Nov with no statistically significant difference (p¼0.64) between the two months. A 33% increase in total ‘yes’ responses was observed in Nov (n¼320) compared with Sep (n¼241). This increase in ‘yes’ responses in Nov was similar for correct (37%) and incorrect (27%) replies with no statistical dif- ference between the two (p¼0.089). Conclusions: BCAM failed to increase hospital staff’s awareness of breast cancer risk factors, paradoxically a decrease in risk recognition was observed after the BCAM. Stronger strategies than just naming a month for breast cancer are required to enhance public knowledge of the disease. http://dx.doi.org/10.1016/j.ejso.2014.02.117 P118. Free hand breast core biopsies in a selected group are as good as image guided biopsies Asad Parvaiz, Ali Ismail, James Hall, Ehsan Rahman, Brian Isgar New Cross Hospital, Wolverhampton, UK Introduction: There has been an increasing trend towards image guided core biopsy than free hand biopsy for symptomatic breast lesions. We aimed to study our own practice. Methods: All patients presenting to one stop breast clinic needing core biopsies over a 24 month period under a single consultant were prospec- tively included in this study. Information was collected regarding method & number of biopsies, time delay between patient initial assessment, core biopsy and results given. Results: 548 consecutive breast core biopsies were performed over this 24 month period. Conclusions: 75% of the total and 92% of the palpable lesion biopsies have been performed free hand with no significant difference in diagnostic sensitivity compared with image guided biopsies. In a selected group, free hand biopsies provide the added advantage of early diagnosis and subse- quent treatment. http://dx.doi.org/10.1016/j.ejso.2014.02.118 Table: Relationship between LOS and axillary procedure Length of Stay (days) Axillary Surgery 0 1 2 3 4 5 6 7 9 10 Total None 4 7 1 12 Sentinel Node Biopsy 8 84 4 1 97 Sampling 1 4 1 6 Clearance 8 68 10 3 4 3 1 1 98 Bilateral 1 3 4 Total 21 164 17 4 4 3 1 1 1 1 217 Risk factors for breast cancer Correct responses in percent (%) Sep 2012 Nov 2012 Being female 56 77 High alcohol consumption 41 54 High body mass index 50 41 Hormone replacement therapy 59 72 Contraceptive pill 59 79 Smoking 71 72 Family history 50 46 Free hand biopsy Image guided biopsy p Value Total number (%) 413 (75%) 135 (25%) Palpable lesions (total 451) 413 (92%) 38 (8%) Median number of cores taken per biopsy (range) 2 (1-8) 4 (1-10) < 0.0001 Median number of days lapsed between patient assessment and core biopsy (range) 0 (0-50) 8 (0-42) < 0.0001 Median number of days lapsed between patient assessment and result given (range) 7 (2-52) 16 (2-57) < 0.0001 Sensitivity 400/413 (96.8%) 134/135 (99.2%) 0.19 644 ABSTRACTS

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Page 1: Breast cancer awareness month: Is it a waste of time?

Risk factors for breast cancer Correct responses in percent (%)

Sep 2012 Nov 2012

Being female 56 77

High alcohol consumption 41 54

High body mass index 50 41

Hormone replacement therapy 59 72

Contraceptive pill 59 79

Smoking 71 72

Family history 50 46

644 ABSTRACTS

P116. Day case mastectomy: Feasibility, length of hospital stay and

patient satisfaction

Sekhar Marla, Christopher McEvoy, Amtul Carmichael

Russells Hall Hospital, Dudley, UK

Introduction: Increasing breast-conserving surgery and less axillary

surgery (sentinel node biopsy) have lead to a significant reduction in

average length of hospital stay (LOS). Over 30 percent of patients undergo

mastectomies and recent studies have shown day case/ one night stay to be

a safe approach. Having made changes to the surgical pathways for all

breast cancer patients, we assessed the LOS and feasibility of day case

mastectomy at our hospital.

Methods: All mastectomies with or without an axillary procedure per-

formed over the past 2 years were included. Patient demographics, type of

surgery, LOS and patient satisfaction (using a modified Quality of Recov-

ery-40 postal questionnaire) were assessed. Patients who underwent imme-

diate reconstruction were excluded.

Results: From January 2012 to November 2013, 217 women under-

went mastectomy. Median age was 71 (36-93) years. 85% (n¼185) under-

went surgery as day case/one night stay. 10% (n¼21) were discharged the

same day. Patient satisfaction results are awaited.

Table: Relationship between LOS and axillary procedure

Length of Stay (days)

Axillary Surgery 0 1 2 3 4 5 6 7 9 10 Total

None 4 7 1 12

Sentinel Node

Biopsy

8 84 4 1 97

Sampling 1 4 1 6

Clearance 8 68 10 3 4 3 1 1 98

Bilateral 1 3 4

Total 21 164 17 4 4 3 1 1 1 1 217

Free hand

biopsy

Image guided

biopsy

p Value

Total number (%) 413 (75%) 135 (25%)

Conclusions: With changes in the surgical pathway, majority of mas-

tectomy patients can be managed as day case/ one night stay irrespective of

axillary procedure performed. Results of patient satisfaction survey would

advise improvements in the pathway.

http://dx.doi.org/10.1016/j.ejso.2014.02.116

Palpable lesions (total 451) 413 (92%) 38 (8%)

Median number of cores

taken per biopsy (range)

2

(1-8)

4

(1-10)

< 0.0001

Median number of days lapsed

between patient assessment

and core biopsy (range)

0

(0-50)

8

(0-42)

< 0.0001

Median number of days lapsed

between patient assessment

and result given (range)

7

(2-52)

16

(2-57)

< 0.0001

Sensitivity 400/413

(96.8%)

134/135

(99.2%)

0.19

P117. Breast cancer awareness month: Is it a waste of time?

Asad Parvaiz, Virginia Summerour, Brian Isgar

New Cross Hospital, Wolverhampton, UK

Introduction: Breast cancer awareness month (BCAM) is an annual

international health campaign every October to increase awareness of

the disease. We aimed to assess breast cancer risk awareness amongst hos-

pital staff with relevance to BCAM.

Methods: A short questionnaire of fifteen possible risk factors for

breast cancer was given to the hospital staff nurses. They were asked

to recognise these risk factors as yes/ no/ do not know. The survey

was carried out in two phases; phase 1 was Pre-BCAM, in the month

of September and the phase 2 was Post-BCAM, in the month of

November.

Results: A total of 73 hospital staff nurses were surveyed; 34 in

September 2012 and 39 in November 2012. A 100% response rate was

observed. Median correct response rate was 50% in Sep and 46% in

Nov with no statistically significant difference (p¼0.64) between the two

months.

A 33% increase in total ‘yes’ responses was observed in Nov (n¼320)

compared with Sep (n¼241). This increase in ‘yes’ responses in Nov was

similar for correct (37%) and incorrect (27%) replies with no statistical dif-

ference between the two (p¼0.089).

Conclusions: BCAM failed to increase hospital staff’s awareness of

breast cancer risk factors, paradoxically a decrease in risk recognition

was observed after the BCAM. Stronger strategies than just naming a

month for breast cancer are required to enhance public knowledge of the

disease.

http://dx.doi.org/10.1016/j.ejso.2014.02.117

P118. Free hand breast core biopsies in a selected group are as good as

image guided biopsies

Asad Parvaiz, Ali Ismail, James Hall, Ehsan Rahman, Brian Isgar

New Cross Hospital, Wolverhampton, UK

Introduction: There has been an increasing trend towards image

guided core biopsy than free hand biopsy for symptomatic breast lesions.

We aimed to study our own practice.

Methods: All patients presenting to one stop breast clinic needing core

biopsies over a 24 month period under a single consultant were prospec-

tively included in this study. Information was collected regarding method

& number of biopsies, time delay between patient initial assessment, core

biopsy and results given.

Results: 548 consecutive breast core biopsies were performed over this

24 month period.

Conclusions: 75% of the total and 92% of the palpable lesion biopsies

have been performed free hand with no significant difference in diagnostic

sensitivity compared with image guided biopsies. In a selected group, free

hand biopsies provide the added advantage of early diagnosis and subse-

quent treatment.

http://dx.doi.org/10.1016/j.ejso.2014.02.118