Predictors of responses and sexual function for women in the St George breast boost randomized trial (StGBBT)

s / The Breast 24 (2015) 302e307 304 Resonance Imaging (CEMRI) is currently the most sensitive imaging technique for breast cancer detection; however, it suffers from many drawbacks including high cost, timely accessibility, patient contraindications and low specificity. Previous studies have shown that contrast enhanced spectral mammography (CESM) may have similar diagnostic capability to CEMRI without these associated costs (2). Methods: The study included patients with biopsy proven breast cancer aged 21 years, fit for surgery, and excluded patients with contra-indications to intravenous contrast or CEMRI, candidates for neo-adjuvant chemotherapy, or who had pure in situ carcinoma. Participants underwent both CESM and CEMRI. Studies were independently double read and results benchmarked against the final surgical histopathology, core biopsy histology or one year follow-up imaging. CESM and CEMRI were compared for 1) detection of additional lesions 2) ability to size the index lesion 3) influence on surgical plan and 4) participant satisfaction. Results: A minimum of 19 participants was analysed for each study objective. For the detection of additional lesions (n1⁄421), the addition of CESM to conventional imaging increased sensitivity from 50% to 67% with specificity unchanged (47%). Addition of CEMRI to standard imaging increased sensitivity from 50% to 100% but with considerable reduction in specificity (47% to 7%). The geometric mean of index lesion size at pathology was similar for CESM and CEMRI (n1⁄424). For 19 patients, CESM and CEMRI had identical influence on the surgery plan. Participants preferred CESM to CEMRI (n1⁄434, p1⁄40.0005). Conclusions: Results so far suggest CESM has similar diagnostic capacity to CEMRI and is preferred by patients. References [1] Lobbes M, Smidt M, Houwers J, Tjan-Heijnen V, Wildberger J. Contrast enhanced mammography: Techniques, current results, and potential indications. Clinical Radiology. 2013. [2] Jochelson MS, Dershaw DD, Sung JS, Heerdt AS, Thornton C, Moskowitz CS, et al. Bilateral contrast-enhanced dual-energy digital mammography: feasibility and comparison with conventional digital mammography and MR imaging inwomenwith known breast carcinoma. Radiology. 2013Mar; 266 (3):743-51. PubMed PMID: 23220903. PREDICTORS OF RESPONSES AND SEXUAL FUNCTION FOR WOMEN IN THE ST GEORGE BREAST BOOST RANDOMIZED TRIAL (STGBBT) P.H. Graham, L. Browne , A. Capp , G. Delaney , C. Fox , E.K. Millar , E. Nasser , G. Papadatos . Cancer Care Centre, St George Hospital, Kogarah, Australia; Mater Hospital, Newcastle, Australia; Cancer Therapy Centre, Liverpool Hospital, Liverpool, Australia; Cancer Care Centre, Wollongong Hospital, Wollongong, Australia; Macarthur Cancer Care Centre, Campbelltown Hospital, Campbelltown, Australia Background and purpose: To describe the StGBBT sexual function dataset and associations of response to sexual function assessment. Methods: 688 women participated in the StGBBT as previously reportedi. Quality of life (QOL) and Sexual function data was collected from baseline (pre-radiotherapy) to year 10 annually. Results: 92% completed QOL questionnaires. 81% responded to sexual partner status but responders to other sexual function questions ranged from 59 to 64%. Response rates were maintained to 10 years, were highest in marrieds, lowest in singles, intermediate for divorcees/widows. 97% years and 81% aged 60-79 of married had sexual partners, versus 35% and 5% divorcees, 5% aged 69-79 widows. Of responders, at baseline 60% married versus 75% non-married reported their treated breast did not affect their sexual function. Sexual desire was reported normal in 47% married versus 35% non-married. Sexual frequency never versus at least weekly was reported in 22% and 33% of marrieds, 68% and 17% of non- marrieds. Sexual enjoyment was reported as normal in 60% of married and 47% of non-married. Conclusions: From this unique large long-term Australian data set for sexual function in breast cancer treated women longitudinal data and predictors will be presented. Response rates and sexual partnership status are similar to large community population sexual health surveysii. References [1] Hau E, Browne LH, Khanna S, Cail S, Chin Y, Clark C, Inder S, Swajcer A, Graham PH. Radiotherapy breast boost with reduced whole breast dose is associated with improved cosmesis: The results of a comprehensive assessment from the St George and Wollongong Randomized Breast Boost Trial. Int J Radiat Oncol Biol Phys. 2012; 82(2):682-689. [2] Mercer CH, Tanton C, Prah P, et al. Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual attitudes and lifestyles (Natsal). Lancet 2013; 382:1781-94 WHAT IS THE VALUE OF AXILLARY STAGING IN ELDERLY WOMEN WITH BREAST CANCER? REVIEW OF FOUR YEARS PROSPECTIVE SERIES FROM A SINGLE INSTITUTION K. Murugappan, B. Dijkstra. Department of surgery, Christchurch Hospital, Christchurch, New Zealand Background and purpose: The optimum management of elderly women with breast cancer is complex. Current guidelines are based on expert panel recommendations due to paucity of major trails. 1 In particular, there is lack of evidence to guide axillary management in elderly women (spe- cifically 80 years). Our aim is to evaluate the role of axillary surgery in the management of women aged 80 with breast cancer and its impact on their outcomes. Method: From 2009 e 2013, 130 patients 80 years were identified. Pa- tient demographics, presentation, diagnosis, surgical and non-surgical management and pathological characteristics were derived from a pro- spective database series. Follow up period was a median of 2 years (range 14) Results: Of the 130 patients, 83 (64%) patients underwent Breast +/- axillary surgery, 39 (30%) patients primary endocrine therapy alone; 4 (3%) had combination of endocrine and radiotherapy, 2 (1.5%) patients had primary radiotherapy, 2 patients refused all treatment. 52 patients (62%) whowere clinically or radiologically negative for axillary metastatic lymph node (LN) involvement underwent SLNBx (36 patients) and ALNDx (13 patients). Positive axillary LN was found in 5 patients from ALNDx group and 8 patients had positive SLNBx with 4 of these patients proceeding to completion ALNDx. Chemotherapy was not offered to anyonewith positive axillary LN. Four patients with positive axillary LN underwent radio- therapy. 38 of 57 patients with clinically node negative disease had recommendation for adjuvant endocrine therapy. Patients’ functional and medical comorbidities were analyzed to determine their impact on adju- vant management plan. Conclusion: The vast majority of patients with clinically node negative disease are undergoing axillary surgery that does not alter their subse- quent adjuvant treatment plan. Elderly patients’ functional status and medical comorbidities plays a crucial role in adjuvant management plan- ning. PET SCANS FOR LOCALLY ADVANCED BREAST CANCER AND DIAGNOSTIC MRI TO DETERMINE THE EXTENT OF OPERATION AND RADIOTHERAPY (PET LABRADOR); TROG 12.02

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