498 ABSTRACTS

axillary lymph node dissection (ALND). If USS shows positive node but

there is complete clinical response (CCR) and complete radiological re-

sponse (CRR) post-NAC, for SLNB. If SLNB positive then ALND, if

SLNB negative consider radiotherapy without ALND.

http://dx.doi.org/10.1016/j.ejso.2013.01.165

P130. Sentinel lymph node biopsy is not indicated following a core

biopsy diagnosis of ductal carcinoma in situ unless a mastectomy is

being performed

Simon Pilgrim, Victoria Hepworth, Sarah McDonald, Amy O’Connell,

Simon Pain, Gabor Peley

Norfolk & Norwich University Hospital, Norwich, UK

Introduction: NICE guidance advocates axillary sentinel lymph node

biopsy (SLNB) in patients with a pre-operative diagnosis of ductal carci-

noma in-situ (DCIS) undergoing breast conserving surgery (BCS) who

are at high risk of invasive disease (in our unit: high-grade or mass-forming

DCIS), or who are undergoing a mastectomy. This study aims to establish

whether SLNB is indicated following a core biopsy (CB) diagnosis of

DCIS without invasive disease.

Methods: A computerised database of pathology and operating records

was created. All cases in which CB of breast tissue found DCIS were in-

cluded. Cases where invasive diseasewas also present on CBwere excluded.

Results: 235 patients (76 BCS and 159 mastectomies) underwent SLNB

following a CB diagnosis of DCIS between 2006 and 2011. 73 (31.1%) pa-

tients had invasive disease on final specimen histology (36.8% for BCS,

26.1% for mastectomy). 17 of 235 (7.2%) patients had some SLNB involve-

ment (9 macrometastases, 4 micrometastases, 4 isolated tumour cells). In 4

cases (all mastectomies) SLNB was positive (2 micrometastases, 2 isolated

tumour cells) but no invasive disease was found in the breast.

Conclusion: SLNB is not indicated following a CB diagnosis of DCIS

unless a mastectomy is being performed. If invasive disease is found on

breast specimen histology, SLNB can be carried out at a later date. Even

in this population of patients with high risk of invasive disease, this strat-

egy would reduce axillary morbidity for 63.2% of BCS patients but at

a cost of an additional procedure in 36.8%.

http://dx.doi.org/10.1016/j.ejso.2013.01.166

P131. Male Breast Cancer and the role of genetic testing: should we

introduce SIMBA (Screening In Male Breast cAncer)?

SIMBA Study Group On Behalf of Mersey Research Collaborative

Mersey Research Group for Surgery (MeRGS), Mersey, UK

Introduction: Breast cancer affects approximately 370 men each year

in the UK. Men with BRCA2 mutation are 8 times more like to be affected

than the general population. Little data from the UK exists pertaining to

this topic. We evaluated incidence of male breast cancer in Merseyside,

to assess the proportion of BRCA2 carriers and to explore if there is a ben-

efit of known male gene carriers being offered screening.

Methodology: Retrospective cohort study of 5 centres in Merseyside

reviewed male patients with breast cancer identified between 01/01/2000

and 31/10/2012. Data collected on family history, BRCA gene testing, his-

tology and treatment.

Results: Forty-five patients identified; median age 70 years (range 37-

93). All presented with a breast lump. Forty-one (91%) underwent mastec-

tomy; 36 (80%) had grade 2/3 disease; 100% were ER+. Fifteen (33%) had

involved lymph-nodes and 10 (22%) had lymphovascular invasion. All pa-

tients had anti-endocrine therapy, with 6 (13%) also undergoing chemo-

therapy. Six (13%) had a family history of breast cancer, 5 (11%) went

on to BRCA testing, with only one (2%) having a documented BRCA2

mutation. The 5 year survival rate was 62% (16/26). 36% (4/11) of re-

corded deaths were related to breast cancer.

Conclusions:The regional incidence ofmale breast cancer inMerseyside

appears lower than the national average. Our findings suggest men have

higher grade, ER+ tumours and are likely to undergo mastectomy. Only

a small proportion underwent BRCA testing, raising the question should

we be testing all male breast cancers? Further work is ongoing evaluating

BRCA2 rate in our region, in conjunction with the clinical genetics unit.

http://dx.doi.org/10.1016/j.ejso.2013.01.167

P132. Information required for surgical decision making in young

women with breast cancer

Alejandra Recio-Saucedoa, Sue Gertyb, Claire Fostera, Ramsey

Cutressb, Diana Ecclesb

a Faculty of Health Sciences, University of Southampton, Southampton,

Hampshire, UKbCancer Sciences Academic Unit and University of Southampton Clinical

Trials Unit, Faculty of Medicine, University of Southampton and

University Hospital Southampton Foundation Trust, Southampton,

Hampshire, UK

Introduction: The POSH study was designed to determine if prognosis

of young patients with sporadic breast cancer differed from those with he-

reditary breast cancer. Additionally it is not known if young patients with

breast cancer have different information requirements to enable them to

make informed decisions about oncological breast cancer surgery (breast

conservation versus mastectomy).

Aims: To explore young women’s information needs and the timing of

information delivery during the treatment pathway.

Methods: Following ethical approval (REC-Reference: 10/H0504/87)

twenty women who had a diagnosis of breast cancer at �40 were inter-

viewed. In-depth semi-structured interviews allowed for wide and rich ex-

ploration of women breast cancer experience. Transcribed interviews were

analysed under the Framework approach based on a theme categorisation.

Results:A comprehensive list of relevant information for decision-mak-

ing was identified during the one-to-one interviews. Timing to deliver the in-

formation and preferred format was explored in a focus group of recently

diagnosed young women. Information about impact of treatment on health

and life and factors influencing the decision were two of the most frequently

coded data. Eleven women discussed not having had enough information in

a range of topics, from diagnosis to side effects of treatment in the short and

long term, fertility preservation and reconstructive surgery options.

Conclusions: Women identify surgeon’s advice as the main source of

information for surgical treatment decision-making. Young women also

observe however, that communication about surgery can be improved. De-

velopment of surgical information targeted specifically at young women

with breast cancer is in progress.

http://dx.doi.org/10.1016/j.ejso.2013.01.168

P133. Immediate free nipple-areolar complex autograft e A lost

opportunity?

Fiona Ross, Sunil Amonkar, Pud Bhaskar

University Hospital of North Tees, Stockton-on-Tees, UK

Introduction: National mastectomy and breast reconstruction audits

have shown an increase in uptake of immediate breast reconstruction

(IBR). However, fewer patients are willing to undergo nipple reconstruc-

tion. The nipple is often discarded with IBR which may be a lost

opportunity.

Method: All patients having skin sparing/reducing mastectomies with

latissimus dorsi or inferior dermoglandular flap based IBR were considered

for free grafts. Standard procedure involved initially harvesting a full