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Publication P047: Avoiding unnecessary biopsy for benign breast masses in women under the age of 30(Elsevier, 2020-06) Cook, Nicola; Batt, Jeremy; Patel, Ashish; Humphreys, Alexandra; Hunt, Richard; Vinnicombe, Sarah; Cornford, Eleanor; Massey, Eleanore; Cook, Nicola; Batt, Jeremy; Patel, Ashish; Humphreys, Alexandra; Hunt, Richard; Vinnicombe, Sarah; Cornford, Eleanor; Massey, Eleanore; Medical and DentalIntroduction: Fibroadenomas (FAD) are benign breast lesions composed of both stromal and epithelial elements. Association of Breast Surgery (ABS) guidelines suggest histological assessment of any lesions in women >25years old, even if a fibroadenoma is suspected clinically and radiologically propose a non-biopsy policy for fibroadenomas in women aged between 25-30 years when strict clinical and radiological criteria are fulfilled. Here we review our local practice, with the view to adopting a similar non-biopsy protocol.Publication Neo-Adjuvant chemotherapy and its affects to the axilla-Can we safely downgrade axillary surgery to mirror the approach in the breast(Wiley, 2020-08-06) Batt, Jeremy; Chambers, Alice; Al-Allak, Asmaa; vestey, sarah; Hunt, Richard; Massey, Eleanore; Fowler, Clare; Batt, Jeremy; Chambers, Alice; Al-Allak, Asmaa; Vestey, Sarah; Hunt, Richard; Massey, Eleanore; Fowler, Clare; Medical and DentalThe use of neo-adjuvant chemotherapy (NACT) to downgrade surgery in the breast from mastectomy to breast-conserving surgery is well-established. In certain patients, the use of adjuvant axillary radiotherapy can be safe and effective in place of axillary node clearance. What remains less clear are the alternative surgical options to the axilla following NACT. The aim of this study was to examine the effects of NACT in the axilla and whether downgrading axillary node clearance to axillary conserving surgery to mirror the approach in the breast may be a viable and safe practice. Patients undergoing neo-adjuvant chemotherapy were identified over a seven-year period between 2010 and 2017. Surgical plans were compared with pre- and post-chemotherapy. Histological information at the time of diagnosis was compared to surgical excision specimens. 349 patients were included for analysis, and 264 had axillary status documented at diagnosis. The average patient age was 51 years, and Grade 3, ER-positive, and Her2-negative cancers made the biggest histological subgroups. Complete pathological response (CPR) was seen in the breast in 27% of cases. 19% of patients requiring mastectomy had their surgery downgraded. Following NACT, axillary CPR was seen in 42% of patients and residual axillary nodal burden was limited to four nodes in 73% of patients. Axillary conserving surgery may be a safe alternative surgical approach in the downstaged axilla following neo-adjuvant chemotherapy. Advances in perioperative identification of suspicious nodes may be needed to facilitate progress.Publication Self-retaining retraction technique for axillary lymph node dissection for breast surgeons(Royal College of Surgeons of England, 2020-08-18) Humphreys, Alex; Patel, Ashraf; Hunt, Richard; Humphreys, Alex; Patel, Ashraf; Hunt, Richard; Medical and DentalNo abstract availablePublication P111. 'Attend anywhere': A virtual success? Patient feedback from breast nurse specialists using 'attend anywhere' technology during the COVID-19 pandemic(Elsevier, 2021-05-04) Johnstone-Burt, Antigone; Giles, Samantha; Wright, Rachael; Johnstone-Burt, Antigone; Giles, Samantha; Wright, Rachael; Nursing and Midwifery RegisteredResearch has shown that remote consultations, conducted in an outpatient setting, are likely to improve clinical outcomes and benefit adults who have difficulty accessing their healthcare setting. The secure video-call system "Attend Anywhere" has proven useful for the breast care nursing team to help facilitate contact and support during the COVID-19 pandemic. Voluntary questionnaires were added to the end of each virtual consultation. Data from the questionnaires (N=40) was collected and divided into four broad categories: 'user-friendliness', 'patient convenience', 'patient satisfaction' and demographic information. This information was used to draw initial conclusions about Attend Anywhere's potential to improve patient care during the pandemic. The results were positive, centring on ease of use and patient satisfaction. A quarter of patients found the video consultation less stressful than a face-to-face session, reporting it as a "better" or "significantly better" experience, and 100% of users felt they were able to communicate everything they wanted to during the call. Staff and patients found the technology easy to use. Results also showed that patients reported feeling comfortable to reveal themselves physically and emotionally in the "safe space" of their own homes. Feedback shows that the platform has proven useful to service users, enabling Breast Care Nurses to provide effective psychological support and virtual physical assessments. Although video calls will not replace physical consultations, they have proven to be a good substitute to face-to-face appointments, adding another string to the BCN's communication bow and offering patients a convenient and flexible alternative to travelling into clinic.Publication Formalised mentorship within oncoplastic breast surgery training - Is it indicated? A systematic review(Elsevier, 2022-05-06) Hunter-Smith, Alison; Humphreys, Alexandra; Pearce, Belinda; Dash, Isabella; Shah, Reena; Chagla, Leena; Humphreys, Alexandra; Medical and DentalIntroduction: Oncoplastic breast surgery places unique psychosocial and multi-disciplinary demands upon its trainees. As such, a healthy balance of personal and professional spheres are necessary to cultivate resiliency, emotional intelligence and self-awareness. Whilst the UK is a global leader in oncoplastic breast surgery training, no current trainee self-development scheme exists beyond the clinical/ educational supervisor. With the introduction of the revised breast surgery curriculum in August 2021, we assess whether a formalised mentorship programme would benefit oncoplastic breast surgery training.Publication The new breast training curriculum; Can it be successfully delivered?(Elsevier, 2022-05) Merker, Louise; Mitchell, Ben; Chambers, Alice; Donigiewicz, Urszula; Llewyn-Bennett, Rebecca; Cook, Nicola; Llewyn-Bennett, Rebecca; Medical and DentalThe new general surgery training curriculum was implemented in August 2021 with much anticipation. The changes were particularly relevant to breast surgery, with a reduction in the general surgery training required and ability to reduce on-call commitments to aid breast surgery skill consolidation. This was paired with an increase in the number and type of breast surgery index procedures required for CCT. The oncoplastic breast procedures offered regionally has a wide national variation and trainees will need to find ways to circumvent this, especially now that fellowships have become post CCT only.Publication Quality of recovery following day case mastectomies, a service evaluation using patient reported outcomes(Elsevier, 2024-01-12) Shinner, Benedict; Fowler, Clare; Stedeford, Judith; Fowler, Clare; Stedeford, Judith; Medical and DentalIntroduction: The Covid-19 pandemic forced difficult decisions onto hospitals providing oncology surgery. Due to the reduction in bed availability, many centres changed mastectomies to day case procedures. This continued post-covid, with studies showing similar outcomes and minimal readmissions. However, few evaluations looked at the patient experience or the holistic suitability of recovery at home.Publication Phyllodes tumours at gloucestershire hospitals NHS foundation trust breast unit from 2016 to 2023(Elsevier, 2024-05) Humphreys, Alex; Massey, Eleanore; Massey, Eleanore; Medical and DentalNo abstract available