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test.
Conclusion
Pts opinions underlined that a genetic test could help in
facing RT and its side-effect in a more conscious manner,
and it might help clinician to optimize RT. Nevertheless
side-effect are generally perceivable as tolerable, and
preferable to mastectomy or tumor control failure
EP-1197 Results in Breast cancer Patients who
Received adjuvant Radiation after Immediate
Reconstruction
A. Giraldo Marin
1
1
Hospital Universitario Vall d'Hebron, Radiotherapy,
Barcelona, Spain
Purpose or Objective
Prior studies have advocated avoidance of immediate
reconstruction (IR) in breast cancer (BC) patients who
should receive adjuvant radiotherapy (RT), alluding to
worse aesthetic outcomes. Our purpouse is to evaluate the
complication rates and cosmetic results for patients
undergoing postmastectomy radiation therapy (PMRT)
after IR.
Material and Methods
Between June 2010 and March 2016, 25 patients with
locally advanced breast cancer, who underwent modified
radical mastectomy, IR, and PMRT were treated at our
center. RT was delivered to the chest wall ± nodal areas
according to stage, with 6MV and total dose of 50 Gy in 25
fractions. Complications were scored following the CTCAE
4.0 criteria. The capsular contracture was evaluated
following the Baker classification. Cosmesis was rated as
either acceptable or unacceptable to the patient.
Results
The mean age was 46.7 years (range, 33-65). A total of 20
patients underwent tissue expander and 5 underwent
implant (TE/I). Median follow-up (from the start of RT) for
all patients was 18 months (m) (4-48m). 40% of the
patients were never smokers; 28% were smokers and 32%
ex-smokers during RT. 10% and 68% of the patients
received neoadjuvant and adjuvant chemotherapy
respectively, and 17 patients taking Tamoxifen during RT.
After surgery the complications occurred in 15/25
patients: 7 with capsulitis grade (G) 2; 2 with capsulitis
G3-4; 3 with cutaneous suffering and mastitis, extrusion
and hematoma were presented in 1 patient each.
Complications post surgery in 2 patients as were
hematoma and extrusion required additional surgery and
delayed beginning of RT. All patients completed the RT
course without major complications. During RT the only
complication presented was skin erythema (SE) G1-2 seen
in 20 (80%) and G3 in just 5 patients which were all
smokers. During the follow up the major complications
were: capsulitis G3 in 5 patients and G4 in 1; skin
hyperpigmentation was presented in 4 patients, cutaneous
thinning in 6 and 1 patient presented relevant lung
toxicity. At the end of the follow-up, TE Exchange have
been realized in 12 patients with a mean time after RT of
14,3m (9-22), 3 of them are pending of a new corrective
surgery, specialy for improve cosmetic outcomes. We
reported capsulitas G4 in 2 patients after the Exchange;
both were smokers and 1 of them presented extrusion
before RT, therefore she was operated twice. Acceptable
cosmesis was reported in 60% of the patients
Conclusion
Our experiences is limited but in our patients undergoing
PMRT, RT can be safely delivered after IR, with a low
complication rate and good patient satisfaction. In our
patients major complications occurred before RT. Further
studies are needed to define the factors that may be
related to worse aesthetic results.
EP-1198 Low risk breast cancer patients' supportive
care needs and perceptions of follow-up care options
J. Kwan
1
, J. Croke
1
, J. Bender
2
, T. Panzarella
1
, K. Ubhi
1
,
F. Liu
1
, A. Fyles
1
, A. Koch
1
, R. Dinniwell
1
, W. Levin
1
, D.
McCready
3
, C. Chung
1
1
Princess Margaret Cancer Centre- University Health
Network/ University of Toronto, Radiation Oncology,
Toronto, Canada
2
University Health Network, ELLICSR Cancer Survivorship
Centre, Toronto, Canada
3
Princess Margaret Cancer Centre- University Health
Network/ University of Toronto, Surgical Oncology,
Toronto, Canada
Purpose or Objective
Breast cancer is the most common cancer in women and
survival following treatment is rising. Although traditional
follow-up care has been by oncology specialists post-
treatment, literature over the last decade has shown that
non-specialist follow-up care is a safe alternative for
early-stage breast cancer patients. Barriers in
transitioning patients from oncologist follow-up have not
been well characterized. This study aims to assess i) the
existing follow-up practices at a large institution, ii) met
and unmet supportive care needs, and iii) patient views on
alternative care models, particularly involving primary
care and eHealth.
Material and Methods
A cross-sectional survey of well breast cancer patients
attending radiation oncology follow-up appointments from
August 2012 to May 2013 at the Princess Margaret Cancer
Centre (Toronto, Canada) was completed. Eligibility
criteria included English-speaking patients with T2 or
lower tumor stage, node negative status, and ER/PR-
positive breast cancer treated with radiation. Four
domains were assessed: health care service use,
supportive care needs, perceptions of follow-up care
options, and internet usage. Descriptive statistics were
completed for all variables and univariable analyses were
performed to examine relationships between key variables
and domains.
Results
Response rate was 80% (191/259). Respondents had a
mean age of 60 (SD=10.6). Median time since first follow-
up was 21 months. The majority of respondents (161/191;
84%) received follow-up care from greater than one cancer
specialist and had a median of 3 health care professional
visits per year. The most preferred follow-up model was
specialist care at a tertiary centre (178/191; 93%) and the
least preferred models were specialist care through video
conferencing (29/191; 15%) and email (28/191; 15%).
Shared care models involving a specialist and family
physician were modestly accepted (103/191; 54%).
Primary care only follow-up was not well accepted
(35/191; 18%), particularly among patients with higher
education. Respondents who reported few unmet
supportive care needs (p=0.01) or who search online for
health information (p=0.02) were more likely to report
perceived satisfaction with specialist follow-up via
eHealth.
Conclusion