8^th World Congress on Breast Cancer & Therapies July 16-17, 2018 Melbourne, Australia

Theophil Sedloev MD, PhD is a chief of the Breast Unit at the Department of Surgery, Medical University Sofia, Bulgaria. His professional interests include surgical treatment of the breast cancer - breast conserving and oncoplastic surgery with intraoperative radiotherapy for early breast cancer, neoadjuvant chemotherapy and surgery of locally advanced breast cancer. He has published more than 65 papers in reputed journals and has been serving as an editorial board member.

Introduction: Intraoperative radiotherapy (IORT) is a technique for accelerated partial breast irradiation (APBI). IORT offers many advantages comparing to whole breast irradiation (WBI) and other techniques for APBI, including shorter treatment duration and decreased radiation toxicity. Despite the controversies, the application of IORT is increasing nationally. This improves patient’s cosmetic outcome at minimal risk of recurrence and treatment-related toxicity. Establishing IORT as a therapeutic modality requires a multidisciplinary approach to patient selection, work up, surgery, radiation protocols, chemotherapy, and patient follow up. In 2015 we launched the use of IORT during conservative surgery in patients with early breast cancer in Bulgaria. The aim of this study is to investigate the outcomes of application of IORT in Bulgarian patients with early breast cancer (BC) treated in Medical University Sofia Breast Unit. Methods: The patients were selected following the criteria of The Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) Breast Cancer Working Group (2009). The IORT procedure was performed with the electronic brachytherapy device INTRABEAM® (Carl Zeiss Surgical Gmbh, Oberkochen, Germany). Results: Between December 2015 and May 2018 fifty four patients with early BC aged between 44 and 82 years (mean age 61,7) were diagnosed and treated in our Breast Unit. All patients underwent breast conserving surgery (BCS) аnd sentinel lymph node biopsy. A single dose low-energy X-rays (max50kV, 20 Gray) was applied in the tumor bed for between 8 and 36 minutes, according to the size of the tumor and the applicator. All patients were discharged on the first or second postoperative day. During the follow up time of 30 months there were no signs of local recurrence. Discussion: One of the most important advantages of IORT is the delivery of a single fraction of radiotherapy at the time of surgery, directly into either the tumor cavity or the index quadrant. Among the various APBI techniques, the largest randomized controlled trials were conducted on IORT. Along with the data of the big trials our results are encouraging, because no recurrence was observed. In most of the cases the application of IORT prolonged the surgical time with 18-28 minutes, but reduced the waiting times for WBI, the duration of whole treatment and finally - the hospital costs. Conclusion: BCS combined with IORT in well selected patients with early breast cancer is innovative, save, feasible and economically effective technique. It attracts patients because of its significant improvement in convenience and excellent cosmetic outcome. We hope our report will expand its acceptance and utilization.

Will be updated soon

Background & Aim: Body weight change commonly occurs in patients who receive chemotherapy. There was lack of data on weight loss and hematological parameter changes following adjuvant chemotherapy. This study was to evaluate the body weight and hematological parameter changes following adjuvant chemotherapy in advanced breast cancer. Methods: This prospective observational study included 50 advanced breast cancer (Stage III B) subject who were receiving Doxorubicin and Cyclophosphamide regiment. Body weight, Body Mass Index (BMI), Body Surface Area (BSA) and hematological parameter were measured before, after first and second cycles of chemotherapy. Results: There was a significant decrease in body weight, BMI and BSA before and after first and second cycles of chemotherapy, from 60.06 to 58.69 (p<0.05), 25.66 to 25.05 (p<0.05) and 1.58 to 1.57 (p<0.05), respectively. Hemoglobin and total lymphocytes count were also significantly decrease after first and second cycles of chemotherapy, 12.04 to 10.97 and 2,235.61 to 1,894.82/mm3 (p<0.05), respectively. There is no significant decrease in total leukocyte and absolute neutrophil count (p=0.06 and p=0.568, respectively). Conclusion: Body weight, BMI and BSA have significantly decreased after first and second cycles of chemotherapy. Hemoglobin and TLC levels also have significantly decreased but there is no significant decrease in leukocyte and ANC level.

Bin-Bin Cong has completed his PhD at the age of 30 years from University of Jinan. He has published more than 10 papers in reputed journals and has been serving as an editorial board member of repute.

Purpose: Cy754 was combined with Rituximab to prepare a new receptor-targeted tracer for sentinel lymph node (SLN). The appropriate combination ratio of the tracer was identified, the biological property and safety limitation was tested, and the SLN imaging ability of the new tracer was evaluated. Experimental Design: Cy754 was combined directly with Rituximab to prepare Cy754-Rituximab. After centrifugation and purifying, the labeled rate was analyzed by instant thin-layer chromatography-silica gel, the molecular integrity was tested by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and the molecular immune activity was tested by ELLAS. After the acute toxicity and the local toxicity tested, the SLN localization ability of the tracer was evaluated in the SLN animal model. Results: Rituximab was intact and kept the immune activity in the new tracer. The Cy754 labeled rate of Rituximab was 100%. The new tracer was bacteria and pyogen free, and was no toxicity to mice with local injection. After Cy754-Rituximab injection, the fluorescence imaging SLN could find in the SLN animal model. The SLN imagines were stable and clear for 10 hours. The location of SLN identified by the new tracer was accorded with the standard radiotracer. Conclusions: The produce method of the new receptor-targeted tracer for SLN is simple, effective, and no radioactive burden. The new tracer was safe with local injection. It could make only SLN imaging with appropriate injection dose and could be used in the study of SLN.

Yick completed his medical studies in the University of Adelaide, he is currently a SET general surgery trainee with the Royal Australiasian College of Surgery in South Australia. He also has a Masters of Public Health and is pursuing a Masters in Health Administration.

Background Neoadjuvant chemotherapy (NACT) has become an important part of managing breast cancer internationally. NACT has the potential to downgrade disease to allow less morbid operations and better prediction of prognosis based on response. Purpose To analyse the use of NACT in Australia and compare internationally. Methods A literature search of published data regarding use of neoadjuvant therapy in breast cancer was performed together with a review of the BreastsurgANZ Quality Audit data. Results Reports from the National Cancer Data Base from America shows 17% and 79% use of NACT in stage II and stage III disease respectively. The use of NACT also increased from 2006 to 2011 in the United States (13.9% to 20.5%). The average use of neoadjuvant chemotherapy in Australia is 4.43% of all breast cancer in 2011-2016. The rate of use risen from 3.08% in 2011 to 6.65% in 2016. For tumours larger than 20mm, the use of NACT has risen from 6.79% in 2011 to 15.16% in 2016. 8.8% of triple negative cancer received NACT in the study period. Conclusion This is the first study reporting the rate of NACT in Australia. While there is a rise in the use of NACT, this is less than the United States.