502 ABSTRACTS

Results: 51% of the clinic letters were sent to the patients. Two con-

sultants comprised of 26% that were primarily addressed to the patient

while the other 25% was mainly achieved by one other consultant. There

was only one letter that indicated that the patient had declined to receive

the letter. 54% of the letters were in freeform and 46% were in a mix of

freeform and pro-forma. Collectively, 90% of the letters included clinical

presentation and follow-up with 82% indicating the working diagnosis but

again, there was a variation between the consultants and clinics.

Conclusion: Currently, the department is not fully complying with the

DoH guideline and should endeavour to improve this. The letters include

varying information and a uniform pro-forma with additional freeform is

also recommended to ensure all important clinical information is included.

http://dx.doi.org/10.1016/j.ejso.2013.01.181

P146. Breast self-examination: A novel health promotion medium

Thomas Lewis

University of Warwick, Coventry, UK

Introduction: The rapid increase in popularity of mobile technology

amongst the general population mean that medical ‘apps’ could provide

a new medium for health promotion and breast self-examination. This

study aims to quantitatively identify the number of breast self-examination

apps available and qualitatively assess the common features of these apps.

Methods: A systematic search of the Apple iTunes store was carried

out using keywords related to breast screening and self-examination.

Apps that failed to meet strict inclusion criteria were discarded. Each sum-

mary page was reviewed and data extracted using a standardised form.

Results: Initially 369 apps were identified. These could be broadly

broken down into 3 subject categories e breast cancer and self-examina-

tion apps, breast-feeding apps and irrelevant ‘spoof’ apps. 5.4% (n¼20)

met the inclusion criteria. Only 5 were also available for the Android plat-

form. The majority (n¼18) were free to download. Features common to

these self-examination apps included:

� Questionnaire related to breast ‘red flag’ signs and symptoms

� Instruction guidance in the form of images or video

� Advice to seek medical attention if appropriate

� Automated reminders to complete self-examination

Conclusions: There are a number of apps with useful functionality

available which healthcare professionals can recommend for breast self-ex-

amination purposes however it is unlikely that a patient will be able to re-

liably find these apps themselves given the number of irrelevant ‘spoof’

apps available. Mobile technology offers a number of advantageous fea-

tures over traditional methods. Further research needs to evaluate the effi-

cacy of mobile apps for breast self-examination purposes.

http://dx.doi.org/10.1016/j.ejso.2013.01.182

P147. A retrospective cohort analysis: Are prophylactic antibiotics

required prior to needle localised breast surgery?

Delme Luff, Loraine Kalra, Akhil Johri, Richardo Bonomi

Worthing Hospital, Worthing, West Sussex, UK

Introduction: Breast Cancer is the most common female cancer, result-

ing in the highest rate of female cancer related mortality.Wide local excision

is the commonest surgical procedure performed for breast cancer and com-

monly requires needle localisation. Prophylactic antibiotics have been shown

to lower the risk surgical site infections in several specialties. However, their

use in breast cancer surgery is controversial. We have retrospectively

examined the rate of surgical site infections after needle localised breast sur-

gery and whether this was improved with peri-operative antibiotic cover.

Method: Retrospective analysis of infection rates for all needle local-

ised breast surgery at Worthing Hospital between 31/10/11 and 30/4/12.

One surgical team routinely prescribes peri-operative antibiotics and the

other does not. Theatre lists were retrieved from the hospital database.

The breast care nurses notes were reviewed for evidence of surgical site

infections as per the CDC/NHSN surveillance definitions. The hospital da-

tabase was also reviewed for post operative wound culture results.

Results: A total number of 92 needle localised breast surgical pro-

cedures were performed (51 who received prophylactic antibiotics and

41 who did not). Infection rates were 11.76% and 17.7% for the anti-

biotic group and the control group respectively. This difference was

found not to be statistically significant (OR¼0.61 ((95% CI 0.20,

2.10), RR¼0.69 (95 % CI 0.25, 1.89), RRR¼31.1% (95% CI

-0.89,0.75), NNT¼18.83)

Conclusions: This study suggests that there is no benefit for prophy-

lactic antibiotics for needle localised breast surgery. Double blind rando-

mised placebo control studies would help strengthen this evidence.

http://dx.doi.org/10.1016/j.ejso.2013.01.183

P148. A new level 1 oncoplastic technique for breast conserving

surgery: Rotational glandular flap

Eleanore J.D. Massey, Pedro Gouveia, Claude Nos, Isabelle Sarfati,

Krishna Clough

L’Institut du Sein, Paris, France

Introduction:When performing conservative surgery for breast cancer,

breast reshaping can be a challenging procedure. This is particularly true for

upper inner quadrant tumours. Level 1 oncoplastic surgery techniques, i.e.

advancement or rotation of glandular flaps into the cavity should preferen-

tially be performed when less than 20 per cent breast volume is excised.

Method: A new Level 1 OPS technique based on the rotation of a wide

centro-lateral glandular flap into the cavity is described.

Results: The principle of the technique is to create a centro-lateral

glandular flap after extensive undermining of the skin and nipple areolar

complex. This flap is then rotated medially into the excision cavity to

fill the defect.

Conclusion: The rotation glandular flap is a new technique for use fol-

lowing a wide excision. It should be used in glandular, not fatty, breasts,

and when standard closure of the cavity would not leave a satisfactory cos-

metic result.

http://dx.doi.org/10.1016/j.ejso.2013.01.184

P149. Effectiveness of breast cancer follow up in hospital

Eisa Nael, Nikky Adamthwaite

Stafford Hospital, Stafford, UK

Aims:� Review breast cancer follow up practices

� Explore patients opinion on follow up arrangements

NICE clinical follow up guidelines:

� Patients may choose follow up in primary, secondary or shared care

� Agreed written care plan should be recorded by a named healthcare pro-

fessional(s) with a copy to GP and patient

� Care plan should include

i. Named healthcare professional

ii. Symptoms and signs to look for

iii.Contact details for immediate referral