European Journal of Surgical Oncology 46 (2020) e1ee10 e7

had risk reduction alone and in 4 both. There were 6 unplanned read- Table 1:
missions (4 patients) and 7 re-operations (4 patients, 2 operations for
audit-excluded contralateral procedure), culminating in 2 implant ex- Patient characteristics Chest wall Therapeutic Level 1
changes and 1 implant loss 50 days following initial surgery despite perforator mammoplasty (35) BCS (77)
flaps (22)
complete mesh integration.
Conclusion: Interim implant loss at 1 month is 0/19 and 1/19 (5.3%) pa- Symptomatic 21 26 31
Median age (years) 54(31-78) 55(38-86) 63(35-88)
tients (1/30, 3.3% of implants) at 3 months. All outcomes will be reported
Median BMI 25(17-33) 30(20-44)
with minimum 3 months follow-up.
Bra cup D and above 4 27
Invasive 21 31 68
Median size on radiology 23 (11-46) 27 (10-76) 14 (4-50)
21. AUDIT OF BREAST RECONSTRUCTIONS IN POST NEOADJUVANT in mm
SYSTEMIC THERAPY PATIENTS Neoadjuvant 7 11 11
chemotherapy
Fatima Mansour, Joseph Meilak, Sadaf Jafferbhoy, Eisa Nael, Pragnya
Chigurupati, Kirti Katherine Kabeer, Ammara Hasan, Vallipuram Short term outcomes:
Gopalan, Sekhar Marla, Sankaran Narayanan, Soni Soumian. Royal Stoke Complications needing 0 1 haematoma 2 haematomas
intervention
University Hospital, Stoke-on-Trent, United Kingdom
Re-excision/mastectomy 5 4 11
Locoregional recurrence 0 0 0
Introduction: Neoadjuvant chemotherapy is increasingly utilised in the Distant metastasis 2 1 1
treatment of aggressive breast cancers, as per NICE guidelines (2018).
There are concerns that this could potentially impact patient recovery
following extensive oncoplastic procedures. The literature regarding this is
limited and conflicting. We aimed to assess the impact of neoadjuvant Conclusion: There is no significant difference in short-term outcomes
chemotherapy (NACT) on patients undergoing immediate breast between CPF and TM. More high-quality evidence is required to support
reconstructions. their oncological safety.
Method: A retrospective single centre audit of complication rates
following immediate breast reconstruction in post NACT patients between
January 2014-2019 was performed. The procedures performed included 23. DAY-CASE MANAGEMENT OF MASTECTOMY WITH IMMEDIATE
myocutaneous and perforator flaps, therapeutic mammoplasty and RECONSTRUCTION WITH ACELLULAR DERMAL MATRIX: IS IT SAFE
implant based reconstruction (IBR). Demographic data, length of stay, AND EFFECTIVE?
biochemical measurements, rates of wound infection, haematoma,
explantation rates and return to theatre, were collected. For comparison a Hudhaifah Shaker, Nidhi Anu Raj Leena, Victoria Mayers, Vimmuti
cohort of patients with similar characteristics who underwent primary Muralikrishnan, Amar Deshpande. Royal Albert Edward Infirmary,
reconstruction without NACT, during the same period, were included. Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United
Results: Sixty patients were included in the study (30 post NACT vs 30 Kingdom
controls). There were 36.6% that underwent IBR, 40% flaps and 23.3%
mammoplasties. Overall, there was no significant difference between the Introduction: Day-case breast surgery improves patient satisfaction and
two groups in complication rates (26.7% vs 20.0% p¼0.5) or length of stay efficiency. We aimed to audit day-case management of mastectomy with
(1.93 vs 1.73 days). Hypoalbuminemia (26.7%) and low WCC (43.3%) were immediate reconstruction with acellular dermal matrices (ADM).
prevalent in the NACT group but this was not associated with increased Methods: A case note review was performed to collect clinicopathological
complication rates. data on 47 patients who underwent day-case skin-sparing (SSM) or
Conclusion: Our audit suggests that NACT does not cause a significant nipple-sparing (NSM) mastectomy with immediate implant/ADM recon-
increase in post-operative morbidity. Further studies with larger numbers struction between October 2017 and September 2019.
will be required to validate these results. Results: Median age was 52 years (range 37-74). Thirty-two patients (68%)
had an SSM and 15 (32%) had a NSM. Two patients (4%) had risk-reducing
mastectomies and 45 had treatment of invasive cancer or DCIS. Mean
22. SHORT TERM OUTCOMES OF CHEST WALL PERFORATOR FLAPS tumour size was 33.3mm (range 7-85mm). Forty-two (89%) patients went
VERSUS THERAPEUTIC MAMMOPLASTY home on the day of surgery. No patients required re-operation in the first
48 hours. Five patients (10.6%) developed post-operative infections. Eight
Samreen Khan, Abiodun Adigun, John Mathew. North West Anglia NHS patients (17%) developed superficial skin necrosis. Five patients (11%)
Foundation Trust, Peterborough, United Kingdom suffered an implant loss. Two implants were lost in the first 30 days and
three were lost between 48 and 76 days post-operatively. Two patients
Introduction: Chest wall perforator flaps (CPF) and therapeutic mam- (4.3%) required an unplanned return to theatre within the first 30 days
moplasty (TM) are often done in patients with anticipated poor cosmetic with a further 5 (11%) returning to theatre between 30 and 90 days post-
outcome with level 1 breast conservation surgery (BCS). The aim of our op. No patients were re-admitted post-operatively.
study was to assess the short-term outcome of CPF and TM. Conclusion: We have demonstrated close to 90% day-case success rate for
Methods: Review of a prospectively collected data of BCS between Sep mastectomy with immediate reconstruction. Compared to UK national
2016 and Dec 2019 by a single surgeon. Data analysed using Chi-squared standards set in the iBRA study (Lancet Oncol 2019), our small cohort has
test and independent t test, and a P value of < 0.05 was considered demonstrated lower or comparable post-operative complication, implant
significant. loss and re-operation rates. This early data does suggest that day-case
Results: There was no statistically significant difference between CPF and mastectomy with immediate ADM reconstruction is safe and may also be
TM with regard to patient characteristics except for BMI as significantly efficacious.
more patients in TM group had higher BMI (P <0.05) as shown in Table 1.
There was no statistically significant difference in the short-term outcome
between CPF and TM (P> 0.05) after a median FU of 16 months (1-39).