Abstract book 6th RMS 16.indd

WEDNESDAY
21 November 2012
Hall A1 Session 1
Plenary Session: Breast Cancer
Update
247
Stereotactic Technique in Breast
Pathology
Amal Smadi MD, Radiology (Jordan)
130 stereotactic breast biopsies were
performed in the breast imaging unit,
radiology department, K.H.M.C ,between
November 2010-September 2012.
Biopsies were performed for abnormal
breast calcifications, non-palpable
breast masses or architectural distortion.
Pathological results of these biopsies were
collected and reviewed.
248
Narrow or Wide Margin after Breast
Conserving Surgery in Breast Cancer
Ali Abuseini MD, Breast Surgery (Jordan)
The safety and efficacy of breast-conserving
therapy (BCT) for women with early-stage
breast cancer are well established. BCT
entails wide excision of the tumor and
appropriate nodal evaluation ,followed
by radiation therapy to the breast. There
is broad agreement that successful breast
conservation requires complete tumor
excision, commonly described as a “tumorfree”
or “negative” margin oesection,
but the definition of a negative margin is
controversial.National SurgicalAdjuvant
Breast and Bowel Project (NSABP) trials
requires that tumor cells do not touch
ink,butsubsequent retrospective singleinstitution
studies have suggested that
wider margins confer greater protection
against local recurrence( LR).However,
wider margin require re-excision with
attendant social, psychological and
economic cost, subsequently ends
with mastectomy. But data regarding
the optimal margin is conflicting, the
commonly acceptable margin width is a
2-mm distance from the tumor to the ink.
Herein, we have to discuss the conflicting
and the debatable issues including the
studies were conducted in this subject.
249
Extending the Role of Breast
Conservation
Fiona MacNeill MD, Breast Surgery (UK)
Mastectomy for breast cancer can
be devastating both physically and
emotionally. With better cancer treatments
many women are now cured and so
have to live with this burden for many
years. Breast conservation (always
with radiotherapy) allows a woman to
maintain her body image and supports
more rapid psychosocial adaptation.
However maintaining good quality
breast aesthetics after traditional breast
conserving techniques can be difficult
especially for larger volume resections.
Achieving the balance between aesthetics
and good margins is difficult: however
simple oncoplastic techniques such as
parenchymal remodeling can allow better
aesthetic outcomes.
In addition to enhancing aesthetic outcomes
from breast conserving surgery traditional
indications for mastectomy (large tumours,
locally advanced, multifocality BRCA carrier
etc) can be challenged using modern
multimodality cancer treatments including
oncoplastic surgery. We will discuss:
neoadjuvant chemotherapy and endocrine
therapy to downsize cancers to facilitate
conservation as well as oncoplastic
mammoplasty techniques that allow large
volume resection but with maintenance
of a shapely albeit smaller breast. Such
approaches require careful multidiscipline
team discussion and co-ordination.
250
Immediate vs. Delayed Breast
Reconstruction after Mastectomy
Samher Weshah MD, Plastic & Reconstructive
Surgery (Jordan)
Breast reconstruction after mastectomy
is still a challenging subject in the field
of plastic & reconstructive surgery. It’s a
rapidly evolving branch in which the plastic
reconstructive surgeon plays a major role.
There are two modes of reconstruction:
autologous & prosthetic. Timing of
reconstruction is either immediate or
delayed. The decision on timing & mode
of reconstruction should be combined
between the patient & the surgeon.
www.jrms.gov.jo
136