Mammary Fold pre-ABS Education Day

Professor Roy SpenceFor Mammary Fold members the ABS conference always starts on Sunday afternoon with the pre-Conference Education Day. This year it was held at the beautiful, historic Ulster Hall - the grandest venue that I have attended for this meeting in the last 10 years! I think the surroundings set a precedent for the afternoon’s presentations because they were simply fabulous!

The afternoon kicked off with the Mammary Fold AGM where the outgoing committee summarized their roles and achievements over the past year, and many of the new committee and present regional representatives were welcomed.

Cliona KirwanProfessor Roy Spence, who has been board secretary for the FRCS examinations for ten years, started the ball rolling with a fantastic overview of both parts of the FRCS exam, giving some very sound advice from someone who sits on the opposite side of the table. He imparted useful tips for candidates to use during their viva and presented common approaches that examiners take when questioning. This was an invaluable insight into how to be successful in the exam and the recent changes to expect in 2018.

Mr Stuart McIntosh, Clinical Senior Lecturer in Surgical Oncology at Queens University Belfast, discussed the current evidence behind the use of neo-adjuvant chemotherapy; recording response to chemotherapy; assessing residual disease and relation of pCR to long-term outcome; when to consider NACT and then touched on management of the axilla. In addition, highlighting that pCR/NACT is not affecting current surgical practice with mastectomy rates still high. Also discussed was the proposed NeST study - Neoadjuvant Sytemic Therapy in Breast Cancer - that is hoped will be a successful collaborative effort across the nation.

Cliona Kirwan then followed with an update from San Antonio. Having been to San Antonio I know how overwhelming the presentations and data can be and this was a masterclass in how to simplify and summarise. The presentation was an engaging and comprehensive round up of December’s San Antonio meeting which encompassed a variety of the presented trials including, ‘Are BRCA cancers worse?’, ‘Anti ER-HER2 combinations’, ‘The effects of radiotherapy on reconstructions’, and a summary of the trials on the use of extended adjuvant endocrine therapy as well as an inspiring real-life tale of triumph over adversity from Eric Winer, Professor of Medicine at Harvard Medical School.

Mr Stephen Kirk discussed the corner stone principles of medico-legal practice from Bolam through to Bolitho, and the recent seminal Montgomery case. He also gave an enlightening portrayal of a case from initial complaint to conclusion.

Miss Laura Johnson gave a succinct summary of the important aspects of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) ahead of her talk in the main ABS conference, including how to approach and manage ALCL, with take home messages concentrating on technical aspects of diagnosis and the importance of fully informed consent in implant-based procedures, echoing recent ABS guidance.

Mr James Harvey discussed novel innovations in breast surgery including new localisation techniques (Magseed, Saviscout), although very early in their use within the UK, they appear to have real potential to offer an alternative to wire guidance. This was followed by data on polyurethane implants and current evidence on the emerging pre-pectoral reconstruction technique.

Finally Miss Werbena Hamilton-Burke revealed her experience as a TiG Oncoplastic Fellow including the pros and cons of a fellowship and how the recently implemented curriculum has taken effect.

Overall, a wonderful afternoon arranged by Miss Liz Baker and Mr Rajiv Dave. The event was once again oversubscribed and over forty trainees attended to listen to the varied and eminent speakers.

We then filtered downstairs to the Grand Hall and ABS drinks reception before heading out to CoCo’s for the Mammary Fold annual dinner: fantastic food, drink and company. With thanks to Allergan and Genomic Health for sponsorship and N.I. regional representative Brendan Skelly for making the arrangements, he claims not to have known about the very apt artwork on display!

Written by

Fiona Langlands

Mammary Fold Chair