Risk and Surgical Prevention
Medication to Reduce Risk of Breast Cancer: USPS Task Force Recommendation
Young patients with breast cancer and BRCA mutation have similar survival to sporadic breast cancer patients (POSH trial)
Breast Conserving Surgery / Oncoplastic Conservation
Therapeutic mammaplasty is a safe and effective alternative to mastectomy or standard breast-conserving surgery
Management of the Axilla
Targeted axillary dissection (TAD) has a low false negative rate – removal of clipped node during sentinel node biopsy
RCT Quality of Life Outcomes no better with 1-stage versus 2-stage implant reconstruction
Quality of life improved following PMRT to autologous versus implant based reconstruction
Complications following implant based reconstruction in the UK from iBRA group
Lymphoedema Surgery and Prevention
RCT Lymphoedema rates reduced with reverse mapping
S-LYMPHA (simplified LYMPHA) may reduce rates of lymphoedema after axillary clearance
Breast Angiosarcoma Surveillance Study (BRASS) – A National Audit of Management and Outcomes of Angiosarcoma of the Breast and Chest Wall
The BRASS study is a collaborative project led by practising breast and plastic surgeons in the UK and ROI.
Shave margins reduce positive margin rates
Shave margins reducer re-excision rate by 50% but increase volume of excised tissue
iKnife / REI-EXCISE / Mass Spectrometry
Scientists have developed an "intelligent knife" that can tell surgeons immediately whether the tissue they are cutting is cancerous or not. This has been called a potential 'game-changer' for cancer surgery. Sam Wong elaborates in his article:
"In the first study to test the invention in the operating theatre, the “iKnife” diagnosed tissue samples from 91 patients with 100 per cent accuracy, instantly providing information that normally takes up to half an hour to reveal using laboratory tests.
The findings, by researchers at Imperial College London, are published today in the journal Science Translational Medicine. The study was funded by the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre, the European Research Council and the Hungarian National Office for Research and Technology.
In cancers involving solid tumours, removal of the cancer in surgery is generally the best hope for treatment. The surgeon normally takes out the tumour with a margin of healthy tissue. However, it is often impossible to tell by sight which tissue is cancerous. One in five breast cancer patients who have surgery require a second operation to fully remove the cancer. In cases of uncertainty, the removed tissue is sent to a lab for examination while the patient remains under general anaesthetic." Read the full article here
iBRA-NET – No Innovation without Evaluation
In October the first working meeting of the iBRA Network took place.
59 surgeons have applied to be involved and each has been assigned to one of the four studies in development under the iBRANet banner. The steering groups for each of these met in parallel session on October 29th to finalise protocols, and CRFs with a view to recruitment starting in the New Year. An overarching steering group has also been set up which also had its first meeting on October 29th.
There is now a pathway for breast surgical studies from the ABS Innovation Group, to the Sandpit session and on to iBRANet for implementation.
The 4 studies currently in development are:
Phase II Cohort Study of pre-pectoral implant base breast reconstruction.
Map Bra: CI: Julia.firstname.lastname@example.org
Phase II cohort study of a new mesh for implant reconstruction – Fortiva
3D-SI to assess aesthetic outcome after breast reconstruction: CI: Jennifer.email@example.com
The design and assessment of objective 3d cosmetic assessment of breast reconstruction.
A National Audit of Magseed® localisation of breast lesions. CI James.firstname.lastname@example.org
These studies will be opening to recruitment early in the New Year
If you would like to recruit to any of these studies please contact email@example.com