EP169 - Volume Replacement Perforator Flaps: Introducing a New Service to a DGH Oncoplastic Surgical Unit

Abstract Aims Oncoplastic breast conserving surgery (BCS) has developed to facilitate adequate oncological resection whilst maintaining cosmesis. Volume replacement surgery allows immediate reconstruction with transposition of autologous tissue. One approach is the use of chest wall perforator flaps (CWPF). This increases access for patients to enhanced oncoplastic techniques facilitating BCS, in the setting of larger tumour size, reducing the mastectomy rate in our unit. Our aim was to analyse a series of patients undergoing CWPF in our DGH and determine whether oncological outcomes were comparable to traditional breast conserving surgery. Methods Patients undergoing CWPF reconstruction were identified using theatre records for a period of 12 months (Jan-Dec2023). Data was collected including patient demographics, histopathological findings and post-operative course and treatments. Results A total of seven patients were identified with median age 48 . Range of tumour sizes: 17mm-51mm. All were performed in the immediate setting with all undergoing SLNB. 3/7 required further surgery in the form of re-excision of margins. One patient developed a seroma, requiring aspiration once without further complication. Patient satisfaction is anecdotally high; however, this has not been quantified. Conclusions The utilisation of CWPF within our DGH has shown satisfactory outcomes. Performing these in the immediate setting means some patients have required re-excision of margins and replacement of flaps (similar to local figures for WLE without volume replacement) without impacting patient satisfaction. We advocate that CWPF significantly increases the options available as routine practice for suitable patients. OBCS is possible within the DGH without compromising oncological treatments or cosmesis.