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Therapeutic Mammoplasty yields a high rate of successful primary excision and ultimate breast preservation - initial results from the UK TeaM study

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conference contribution
posted on 2020-05-19, 08:39 authored by E Baker, T Rattay, R O'connell, S Potter

Background: In recent years Therapeutic Mammaplasty (TM) has gained popularity as a technique to excise invasive and pre-invasive breast lesions. It has the dual aims of breast preservation and improved cosmesis. TM techniques often involve larger excision volumes than conventional wide local excision. However there is little existing data regarding positive margin rates and subsequent further surgery resulting in either successful breast preservation or completion mastectomy.

Materials and Methods: Data was collected as part of the TeaM (Therapeutic Mammaplasty) study. This was a prospective multicentre audit looking at the practice and outcomes of TM and was based mainly in the UK. Patients undergoing TM between 1st September 2016 and 30th June 2017 were included. Demographic, pre-operative, operative, oncological and complication data were collected. Operative data included any subsequent operations needed to successfully achieve clear excision margins. The definition of a clear excision margin was determined locally.

Results: 899 procedures were performed on 880 patients from 51 centres. Average excision volume was 126.5g (IQR 50-319g, Range 5-2522g). Average total lesion size was 24mm (IQR 16-38mm, Range 0-145mm). 756 (84.1%) patients achieved complete excision on the first attempt. At this point 134 (14.9%) patients with unsatisfactory margins were reported. For those undergoing a second procedure 79 (59%) underwent margin re-excision, 38 (28%) underwent completion mastectomy with or without reconstruction. 16 patients still did not attain clear margins after the second operation. For those undergoing a third procedure, 6 had a completion mastectomy with or without reconstruction and 6 women had a second attempt at re-excision. 5/6 undergoing a second re-excision achieved clear margins. 1/6 had a further positive margin but underwent a successful third re-excision. In total breast preservation was successfully achieved in 828 (92%) cases. Less than 5% ultimately underwent completion mastectomy.

Conclusions: The vast majority of women undergoing TM successfully achieved breast preservation. This was usually achieved at the first or second attempt with only a few percent requiring a third or fourth procedure to obtain clear excision margins. Under 5% ultimately required completion mastectomy.

History

Citation

European Journal of Cancer Volume 92, Supplement 3, April 2018, Pages S78-S79

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Cancer Research Centre

Source

11th European Breast Cancer Conference (EBCC), Barcelona, SPAIN

Version

  • AM (Accepted Manuscript)

Published in

EUROPEAN JOURNAL OF CANCER

Volume

92

Issue

Supplement 3

Pagination

S78-S79

Publisher

ELSEVIER SCI LTD

issn

0959-8049

eissn

1879-0852

Copyright date

2018

Available date

2018-03-28

Publisher version

https://www.sciencedirect.com/science/article/pii/S0959804918304635

Notes

Abstract only

Spatial coverage

Barcelona, SPAIN

Temporal coverage: start date

2018-03-21

Temporal coverage: end date

2018-03-23

Language

en

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