Oncological outcomes with Vertical Scar Therapeutic Mammaplasty (VSTM)Robert Walker, Simon Hawkins, Sheikh AhmadRoyal Cornwall Hospital, Truro, UKASGBI Conference Glasgow11:30, 2nd May 2013

Wise published his mammaplasty in 1956 (1)VSTM originally designed by Lassus & developed into single vertical incision(2)(3) Proposed advantages VSTM include:Smaller scar with no IMF incisionLess dehiscence/necrosis (c.f. inverted T)Better long-term aesthetic outcome(4)Vertical Scar Therapeutic Mammaplasty (VSTM)(1) Wise, R.J. A preliminary report on a method of planning the mammaplasty. Plastic and Reconstructive Surgery. 1956;17(5):367–375(2) Lassus, C. A technique for breast reduction. Int Surg. 1970;53:69–72(3) Lassus, C. Breast reduction: evolution of a technique--a single vertical scar. Aesthetic Plast Surg. 1987;11(2):107-12.(4) Bouwer, L. et al. Vertical scar versus the inverted-T scar reduction mammaplasty: a 10-year follow-up J Plastic Reconstr Aesthet Surg. 2012 Oct;65(10):1298-304

To evaluate oncological outcomesCompare re-excision rates of VSTM with published rates for conventional breast conservation surgery (BCS)Study Aim

Retrospective analysis June 2009 to December 2012 at Royal Cornwall Hospitals NHS TrustData collected from prospectively recorded electronic patient records Method

AgeExcised specimen weightTumour sizeHistological diagnosisRe-excision ratesMethods - Data

128 patients identified (over 3½ years)Under care of single surgeonMedian age 61y Median specimen weight 84g (σ = 123)Median tumour size 20mm (σ = 16.9)Results

53 cases had DCIS in final histology (41.4%)15 patients had close or involved margins requiring MDT recommendation for further surgery (11.7% re-excision rate). Results

Single surgeonSingle institutionShort term oncological outcomes onlyLimitations

Re-excision rate of 11% compares favourably with conventional BCS of 20% (5) Contributed to a reduction in mastectomy rate at the study institutionFurther data are required to confirm the long-term oncological outcomesConclusions(5) Jeevan, R. et al. (2012) Reoperation rates after breast conserving surgery for breast cancer among women in England: retrospective study of hospital episode statistics. BMJ 345: e4505.

Thank YouThe authors declare no affiliations, relationships, activities or conflicts of interest that require disclosure

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