1573 Can the Technique of Local Perforator Flaps Reduce the Volume of Mastectomies?

Abstract Aim National reported mastectomy rate varies from 25% - 45%. Also, when a reduction therapeutic mammoplasty is needed, symmetrisation of the contralateral side will follow. Can the “relative new” technique of local perforator flaps, reduce the volume of mastectomies and contralateral surgery in a District General Hospital? Method Retrospective review of yearly breast cancer treatment operations in Ipswich Hospital. Results 332 surgical operations performed for breast cancer. 79/332 (23,7%) had mastectomy, 54/332 (16,26%) had therapeutic mammoplasty with symmetrisation contralateral surgery, 32/332 (9,63%) had local perforator Flap Surgery. From the perforator flap operations, 23/32 (23/332: 6,92%) would have mastectomy (+/- reconstruction) and 9/32 (11/332: 2,71%) would have therapeutic reduction mammoplasty with contralateral symmetrisation surgery if this surgical option was not available. 0/32 (0,00%) of the local perforator flaps failed. Conclusions Local perforator flaps have resulted in 6,92% reduction in mastectomy rate (also eliminating the possible need for reconstructions). This was in small volume breasts and lower pole carcinomas and 2,71% reduction in symmetrisation surgery. This reduction also reduces the cost of cancer treatment without compromising oncological outcome or patient satisfaction.

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TP8.1.4 Can volume replacement with local perforator flaps reduce the trauma to patients caused by mastectomies and cost of reconstructions in breast cancer treatment?

British Journal of Surgery ◽

10.1093/bjs/znab362.067 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Georgios Karagiannidis ◽

Caroline Mortimer ◽

Hussein Tuffaha ◽

Inga Peerlinck ◽

Evangelos Mallidis

Keyword(s):

Breast Cancer ◽

Cancer Treatment ◽

Operating Time ◽

Perforator Flap ◽

Oncological Outcome ◽

District General Hospital ◽

Breast Conserving Surgery ◽

Breast Cancer Treatment ◽

Flap Surgery ◽

Perforator Flaps

Abstract Aims Improved screening and raised breast awareness raises the demand for breast cancer treatment. 25% - 45% of breast cancer treatment will be mastectomies, some of them followed by reconstruction. Mastectomy +/-reconstruction is a traumatic procedure which affects quality of life of patients plus extra cost for NHS for reconstruction. Can the “relative new” technique of local perforator flaps, reduce the volume of mastectomies (and subsequently reconstructions) in a District General Hospital? Methods Retrospective review of yearly breast cancer treatment operations from 2017 to 2020 in Ipswich Hospital. Results 1094 surgical operations performed for breast cancer. In 2017, 85/292 (29,1%) had mastectomy and 13/292 (4,4%) had local perforator flap surgery. In 2018, the number of mastectomies was 74/299 (24.7%), while 4/299 (1.3%) patients underwent local perforator flap surgery. In 2019, the amount of perforator flaps increased to 24/305(7.8%) while the mastectomies remained in equivalent percentages [72/305 (23.6%)]. Finally, in 2020, despite the presence of COVID19 and the decrease in surgical management of cancer, 16/198(8.5%) had local perforator flaps surgery and only 34/198 (18%) had mastectomy.0/57 (0,00%) of the local perforator flaps failed. Conclusions Local perforator flaps have resulted in 11.1% reduction in mastectomy rate (also reducing reconstructions). The exchange of mastectomy and reconstruction with breast conserving surgery and local perforator flap reduces the operating time and cost of cancer treatment without compromising oncological outcome or patient satisfaction.

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