Abstract P1-16-08: Breast contour preserving surgery; a matter of patient age?
Authors: van Bommel Annelotte C , Baas-Vrancken Peeters Marie-Jeanne T , Mureau Marc A , van der Heiden - van der Loo Margriet , Smorenburg Carolien H , van Dalen Thijs 
Published: May 2015

Background

Breast cancer treatment is a multimodality treatment with different options for the individual patient, aiming to preserve the breast contour in the vast majority of the patients. Different treatment modalities can be used for this goal: primary breast conserving surgery (BCS), BCS after neoadjuvant therapy and immediate breast reconstruction after ablative surgery. Which treatment strategy is chosen may depend on patient preferences as well as patient age. The aim of the present analysis was to describe the rate of breast contour preserving procedures (BCPP) as related to patient age.

Material and methods

All invasive M0 breast cancer patients diagnosed and operated in the Netherlands between 2011 – September 2013 were selected from the national NABON Breast Cancer Audit.

Primary BCS rates, BCS rates after neoadjuvant therapy, and rates of immediate reconstructions after ablative surgery were calculated for various age groups: &lt;40, 40 to 50, 50 to 70 and ≥ 70 years.

Results

A total of 34.577 patients were identified. Sixty percent (20.583 patients) underwent BCS. Primary BCS rates increased with age: 47%, 60%, 69% in patients aged &lt;40 years, 40 to 50 years and 50 to 70 years, respectively. In patients aged ≥70 the BCS rate was considerably lower (48%).

Immediate reconstructions were performed in 16% of all mastectomy patients. An inverse relationship was observed with patient age; the rate of immediate reconstructions decreased from 38% in patients &lt;40 years to 1% in patients ≥70 years of age. A similar decrease in neoadjuvant therapy was seen over the various age groups in patients treated with BCS from 21% to 4% in patients &lt;40 and ≥70, respectively.

The table shows different treatment modalities. After combining these outcomes the rate of breast contour preserving surgery was similar in patients aged &lt;70 (62-73%).

Table 1. Various treatment modalities for invasive breast cancer patients &lt; 40 years40 – 50 years50 – 70 years≥ 70 yearsPrimary breast conserving surgery47%60%69%48%Breast conserving surgery and neoadjuvant therapy21%14%6%4%Immediate reconstruction with mastectomy38%29%16%1%Breast contour preserving surgery*62%68%73%48%* Proportion of patients with primary breast conserving surgery, breast conserving surgery after neoadjuvant treatment and immediate reconstruction combined with mastectomy.

Conclusions

Patient age affected both the BCS with or without neoadjuvant therapy and the percentage of immediate reconstructions after mastectomy. Overall, more similar percentages in preservation of the breast contour are achieved for various age groups compared to BCS alone. Therefore, combining different treatment modalities into breast contour preserving surgery provides a more complete overview of maintaining the breast contour related to various age groups than BCS alone.

Citation Format: Annelotte C van Bommel, Marie-Jeanne T Baas-Vrancken Peeters, Marc A Mureau, Margriet van der Heiden - van der Loo, Carolien H Smorenburg, Thijs van Dalen. Breast contour preserving surgery; a matter of patient age? [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-16-08.