ABSTRACTS 491

P105. Comparative survival analysis of breast cancer with poor

biological markers

Alison Carter, Vicky Stevenson, Chinedu Chianakwalam

The Breast Unit, William Harvey Hospital, East Kent Hospitals University

NHS Foundation Trust, Ashford, Kent, UK

Introduction:TripleNegative Breast Cancer (TNBC) is biologically ag-

gressive and carries a relatively poor prognosis. The aim of this study is to

compare the survival of TNBC with other related biological subgroups.

Method: The database was reviewed over a 5 year period between July

2006 and June 2011 for three groups of breast cancer patients with differ-

ent biological characteristics:

Group1: ER negative, PR negative and HER 2 negative (TNBC)

Group 2: ER positive, PR negative and HER 2 negative (ER positive

group)

Group 3: ER negative, PR negative, and HER 2 positive (HER 2 pos-

itive group)

Their 5-year overall survival (OS) and breast cancer specific survival

(BCSS) were compared using the Kaplan Meier method.

Results: There were 114 patients in Group 1, 86 in Group 2 and 49 in

Group 3. The age, tumour grade and size were similar. The 5 year OS and

BCSS for the three groups were: Group 1: 65% vs. 72%; Group 2: 74% vs.

79%; Group 3: 60% vs. 69%.

Conclusion: Triple Negative Breast Cancer and ER/PR negative/HER

2 positive patients have a relatively poor prognosis and support the oncol-

ogy trials to optimize and improve their treatment.

http://dx.doi.org/10.1016/j.ejso.2013.01.141

P106. Radiotherapy effects on immediate-delayed implant-based

breast reconstructions using breast-Q patent-reported outcome

measures

Kelvin Y.M. Chong, Andrew Currie, Giles Davies

Kingston Hospital, Kingston, Surrey, UK

Introduction: The consensus on the cosmetic effects of radiotherapy

on implant-based immediate breast reconstructions (IBR) is still unre-

solved while studies focusing on the patient feedback are lacking. We

used a validated patient-reported outcome measure (PROM) called the

Breast-Q questionnaire to look at the patients’ perceived cosmetic effects

of radiotherapy on their IBR and also other technical factors.

Methods: Patients who underwent tissue expander-based IBR followed

by a delayed fixed volume implant exchange from 2008 to 2011 were sent

the Breast-Q questionnaire.

Results: Out of the 132 cases, 94 cases responded (71.2%). There were

81 subpectoral implant-only and 13 implant-assisted latissimus-dorsi re-

constructions. After adjusting for confounding variables, radiotherapy

cases had a lower mean Breast-Q score compare to those who did not

(72 vs 22 cases respectively, mean score 72.2 vs 61.6, p ¼ 0.016). Other

factors such as age, BMI, ASA grade, previous ipsilateral surgery, time

from primary surgery, initial breast size, concurrent and delayed axillary

surgery, contralateral symmetrising procedure, nipple reconstruction, adju-

vant chemotherapy and endocrine therapy did not have any significant ef-

fect on Breast-Q mean scores.

Conclusion: Based on PROM, radiotherapy has a detrimental effect

on cosmetic results of IBR. This should be taken into account when de-

ciding between immediate versus delayed implant-based reconstruc-

tions if patients are concerned with long-term cosmetic results. Other

technical factors such as initial breast size, implant size, nipple recon-

struction and contralateral procedures do not affect patient cosmetic

opinion.

http://dx.doi.org/10.1016/j.ejso.2013.01.142

P107. Audit of outcome following core biopsies grades as B3 e Is

surgical excision biopsy justified?

Lorna Cook, Komal Patel, Ibrahim Ahmed, Abdul Kasem

Medway Maritime Hospital, Kent, UK

Introduction: The aim of this study was to audit outcome of all “B3”

biopsies obtained over a 6 year period, in terms of final histology.

Methods: Data was collected from a prospectively maintained database

of all patients referred for symptomatic or screen detected breast lesions be-

tween 2006-2012. All patients with B3 lesions on core biopsy or C3 cytology

from nipple discharge were included. Information was collected on patient

demographics, biopsy characteristic and final histology following excision

biopsy. Congruency between suggested pathological diagnosis on core bi-

opsy and final histology was determined for each histological subgroup.

Results: Total of 91 patients met inclusion criteria, all but one were

female. 67 had lesions which were screen detected, 24 were symptomatic.

Final histological diagnosis after excision biopsy included: intraductal pap-

illoma (14/91), phyllodes (8/91), sclerosing lesion/radial scar (12/91),

ADH(5/91), in situ carcinoma (20/91) and invasive carcinoma (3/91).Con-

gruency between initial biopsy histology and final histology was greatest in

those diagnosed with phyllodes (8/8 patients) and lowest in those with bi-

opsy ADH (1/17). Of the 23 patients who had a final diagnosis of in situ or

invasive carcinoma, the initial diagnosis suggested by core biopsy was

ADH/ALH (13/23), intraductal papilloma (6/23) and atypical/hyperplastic

ductal proliferation (4/23).

Conclusion: This study confirms the importance of continuing to carry

out surgical excision biopsies for B3 lesions. There should be a high index

of suspicion for in situ or invasive cancer in those with a pre-operative core

biopsy diagnosis of ADH or intraductal papilloma.

http://dx.doi.org/10.1016/j.ejso.2013.01.143

P108. A prospective study comparing preoperative imaging and

explantation findings in patients with silicone breast implants

Layal El-Asira, John Murphya, Alan Redmanb, Joe O’Donoghueb

a Royal Victoria Infirmary, Newcastle Upon Tyne, UKb Spire Washington Hospital, Washington, Tyne and Wear, UK

Introduction: In 2010, Poly Implant Prothese silicone implants (PIP)

were withdrawn from the market due to manufacturing concerns. There are

no published prospective studies confirming imaging findings in patients

with silicone breast implants. We have performed a direct comparison of

imaging results with explantation findings in a cohort of PIP patients.

Methods: All patients implanted from 2000 to 2010 at the Spire Wash-

ingtonHospital were recalled. Patients were offeredMRI imaging (USS if in-

tolerant) and explantation if a rupture was reported. Explantation was also

offered to image negative patients if it was deemed clinically appropriate.

The operative findings were compared to the preoperative imaging results.

Results:119 consecutive patients were imaged, with a median age

of 41.5 and a median implantation time of 6 years. 104 MRI scans

(208 breasts) and 15 bilateral USS were performed. MRI diagnosed 36 rup-

tures (17.3%) and USS 8 ruptures (26.7%) giving a total preoperative rup-

ture rate of 18.5%. At explantation 38/44 ruptures were confirmed. MRI

had a PPV of 86.7% and a NPV of 94.7%. 8 of 9 (89%) ruptures in the

USS group were confirmed with no false positives.

Conclusions: In this study PIP implants acted as a surrogate in determin-

ing the accuracy of MRI for silicone breast implant rupture with a sensitivity

of 0.86 and specificity of 0.94. Caution needs to be observed when interpret-

ingMRI results and counselling patients. USS is still a valuable imaging tool

but numbers in this study are too small to make a direct comparison with

MRI.

http://dx.doi.org/10.1016/j.ejso.2013.01.144