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. 2023 Jul;200(2):163-170.
doi: 10.1007/s10549-023-06924-0. Epub 2023 May 22.

Current practice and provision of oncoplastic breast-conserving surgery in the UK: results of the ANTHEM national practice questionnaire

Charlotte Davies  1 , Lisa Whisker  2 , Joanna Skillman  3 , Douglas Macmillan  2 , Christopher Holcombe  4 , Patricia Fairbrother  5 , Shelley Potter  6   7 ; ANTHEM Study Steering Group
Collaborators, Affiliations

Current practice and provision of oncoplastic breast-conserving surgery in the UK: results of the ANTHEM national practice questionnaire

Charlotte Davies et al. Breast Cancer Res Treat. 2023 Jul.

Abstract

Purpose: Oncoplastic breast-conserving surgery (OPBCS) may be a better option than mastectomy ± immediate breast reconstruction (IBR) for women with breast cancer but studies directly comparing the techniques are lacking. We surveyed UK breast units to determine the current practice of OPBCS to inform the design of a future comparative study.

Methods: An electronic survey was developed to explore the current practice of OPBCS. This included the local availability of volume displacement and/or replacement techniques; number of cases performed; contraindications and approach to contralateral symmetrisation. Summary data for each survey item were calculated and overall provision of care examined.

Results: 58 UK centres completed the survey, including 43 (74%) stand-alone breast and 15 (26%) combined breast/plastics units. Over 40% of units (n = 24) treated more than 500 cancers/year. Most units offered volume displacement techniques (TMs) (97%). Over two-thirds (n = 39. 67%) of units offered local perforator flaps (LPF). Approximately a half of units (10/19) not performing LPF were planning to introduce them in the next 12-24 months. A third (n = 19, 33%) of units routinely performed simultaneous contralateral symmetrisation mostly with two-surgeon operating. There were limited oncological restrictions to OPBCS with no contraindications for multifocal cancers in most centres; 65% of units (36/55) offered OPBCS for multicentric disease. Extensive DCIS was a contraindication in a minority of units.

Conclusions: OPBCS is widely available in the UK but contraindications and approaches to contralateral symmetrisation were variable. Work is now needed to prospectively evaluate the outcomes of OPBCS vs mastectomy ± IBR to support informed decision-making.

Keywords: Immediate breast reconstruction; Local perforator flaps; Mastectomy; Oncoplastic breast-conserving surgery; Therapeutic mammaplasty.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Unit contraindications to therapeutic mammaplasty and chest wall local perforator flaps
Fig. 2
Fig. 2
MDT support for Oncoplastic breast-conserving surgery (OPBCS) in different scenarios
See this image and copyright information in PMC

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