SKIN SPARING MASTECTOMY(SSM) WITH TOTAL AUTOLOGOUS FAT GRAFTING WITH PLATELET-RICH-PLASMA(PrP) VERSUS BREAST CONSERVATION THERAPY(BCS) IN EARLY BREAST CANCER(EBC) PATIENTS: RANDOMISED CONTROLLED TRIAL(RCT) WITH FOLLOW-UP OF 34 MONTHS
Dr. Swathi Prakash, Dr. Neha Gupta, Dr. Anurag Srivastav, Dr. Anita Dhar, Dr. Kamal Kataria, Dr. Piyush Ranjan
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
PROBLEM STATEMENT:
Fat grafting was not widely accepted as large volume reconstruction after Skin sparing mastectomy (SSM), initially due to concerns of Oncologic safety, Tumour surveillance, and Technique efficacy. Recently, well performed large volume fat grafting is generally accepted to be both safe and effective in case series. Still no RCT for total autologous fat grafting has been done. This study will attribute to fill the lacunae.
METHODS:
The study was conducted in the Department of Surgical Disciplines, AIIMS, New Delhi, India. 30 women were recruited with early breast cancer presenting with tumour size of less than or equal to 4 cm without any skin or chest wall involvement. Patients were randomized to SSM and BCS. All cases were followed thereafter, following surgery for quality of life (QoL) score, oncological outcome and cosmetic outcome. EORTC QLQ BR 23 and QLQ-C30 were used for assessing QoL in this study.
RESULTS:
In this study, the item Sexual Pleasure obtained the lowest response rate. Both, SSM and BCS patients reported similar high mean QoL scores with no significant difference on any scale. On a median follow up 34 months, 2(13.3%) BCS group developed ipsilateral breast recurrence but no distant metastasis. 2 patients (13.3) had distant metastasis(pleural) in SSM groups with no local recurrences. Complications related to SSM only, 40% patients have flap sensation and 25% retained NAC sensation. NAC removed in 2 patients (necrosis, margin postive). Related to fat grafting, 14.3% patients had 2 cup size reduction, 57.1% had 1 cup size reduction while 21.4% had no reduction. Complications were fat necrosis(3), infection(1), oil cyst(1) in SSM group and infection(1) in BCS group during follow-up. On a cosmetic scale of 4, 65.5% had excellent score while 10.7% had poor score.
CONCLUSION:
Total autologous fat grafting in EBC patients for a median follow-up of 34 months had no local recurrence. The QoL is comparable with BCS. Other implication of this study would be avoidance of radiation therapy unlike in BCS, total extirpation of all the TDLUs-eliminate the possibility of new breast tumour and using patient’s own fat.
DISCLOSURE OF INTEREST:
There is no disclosure of interest.

**SKIN SPARING MASTECTOMY(SSM) WITH TOTAL AUTOLOGOUS FAT GRAFTING WITH PLATELET-RICH-PLASMA(PrP) VERSUS BREAST CONSERVATION THERAPY(BCS) IN EARLY BREAST CANCER(EBC) PATIENTS: RANDOMISED CONTROLLED TRIAL(RCT) WITH FOLLOW-UP OF 34 MONTHS**
_Dr. Swathi Prakash, Dr. Neha Gupta, Dr. Anurag Srivastav, Dr. Anita Dhar, Dr. Kamal Kataria, Dr. Piyush Ranjan_
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
**PROBLEM STATEMENT**:
Fat grafting was not widely accepted as large volume reconstruction after Skin sparing mastectomy (SSM), initially due to concerns of Oncologic safety, Tumour surveillance, and Technique efficacy. Recently, well performed large volume fat grafting is generally accepted to be both safe and effective in case series. Still no RCT for total autologous fat grafting has been done. This study will attribute to fill the lacunae.
**METHODS:**
The study was conducted in the Department of Surgical Disciplines, AIIMS, New Delhi, India. 30 women were recruited with early breast cancer presenting with tumour size of less than or equal to 4 cm without any skin or chest wall involvement. Patients were randomized to SSM and BCS. All cases were followed thereafter, following surgery for quality of life (QoL) score, oncological outcome and cosmetic outcome. EORTC QLQ BR 23 and QLQ-C30 were used for assessing QoL in this study.
**RESULTS:**
In this study, the item Sexual Pleasure obtained the lowest response rate. Both, SSM and BCS patients reported similar high mean QoL scores with no significant difference on any scale. On a median follow up 34 months, 2(13.3%) BCS group developed ipsilateral breast recurrence but no distant metastasis. 2 patients (13.3) had distant metastasis(pleural) in SSM groups with no local recurrences. Complications related to SSM only, 40% patients have flap sensation and 25% retained NAC sensation. NAC removed in 2 patients (necrosis, margin postive). Related to fat grafting, 14.3% patients had 2 cup size reduction, 57.1% had 1 cup size reduction while 21.4% had no reduction. Complications were fat necrosis(3), infection(1), oil cyst(1) in SSM group and infection(1) in BCS group during follow-up. On a cosmetic scale of 4, 65.5% had excellent score while 10.7% had poor score.
**CONCLUSION:**
Total autologous fat grafting in EBC patients for a median follow-up of 34 months had no local recurrence. The QoL is comparable with BCS. Other implication of this study would be avoidance of radiation therapy unlike in BCS, total extirpation of all the TDLUs-eliminate the possibility of new breast tumour and using patient’s own fat.
**DISCLOSURE OF INTEREST:**
There is no disclosure of interest.

SKIN SPARING MASTECTOMY(SSM) WITH TOTAL AUTOLOGOUS FAT GRAFTING WITH PLATELET-RICH-PLASMA(PrP) VERSUS BREAST CONSERVATION THERAPY(BCS) IN EARLY BREAST CANCER(EBC) PATIENTS: RANDOMISED CONTROLLED TRIAL(RCT) WITH FOLLOW-UP OF 34 MONTHS

We are pleased to welcome you to the Australasian International Breast Congress (AIBC) held jointly with the [Australasian Society for Breast Disease (ASBD)](https://www.asbd.org.au/),[6th World Congress on Controversies in Breast Cancer (CoBrCa)](http://cobrca.org/) and [Breast Surgeons of Australia and New Zealand (BreastSurgANZ) in Brisbane, Australia](https://www.breastsurganz.org/).

The Joint Congress will continue the tradition of directly addressing key issues facing clinicians in their daily practice, including medical oncology, surgery, radiation oncology, breast imaging, pathology, reconstruction, allied health and survivorship issues.

We are delighted to have assembled a stellar international and national faculty and thank all those who have agreed to participate and those who have submitted abstracts. We trust that the program is an informative and enjoyable experience.

Thank you for joining us.