Current research projects
Improving Breast Reconstruction Equity of Access through Stakeholder consultation and Translation into policy and practice (I-BREAST)
The national rate of breast reconstruction in Australia is only around 12%, well below the rate in the UK (up to 21%). Access to the full range of reconstruction options is often limited. This research project will explore factors behind the low and uneven rates of breast reconstruction across Australia. After mapping existing disparities, it will review the latest evidence on potential models of care, incorporate the views of surgeons and other oncological clinicians, breast care nurses and women with breast cancer on ways to improve equity of access, and make recommendations for practice and policy changes to help address disparities in treatment options. Read more
Quality of Life following Immediate, Delayed or no breast reconstruction (QoLID)
This study looks at the impact of the choice of breast reconstruction (immediate, delayed or none) on quality of life measures for women undergoing mastectomy and post-mastectomy radiotherapy (PMRT) for breast cancer. It is a prospective, longitudinal observational study which follows women for five years following their mastectomy. Validated, standardised questionnaires are used to assess their quality of life, pain and aesthetic outcomes prior to mastectomy and then at regular intervals. In addition to these patient-reported outcomes, data will be collected on clinical outcomes such as surgical and PMRT complications, delays in the delivery of adjuvant treatments and long-term outcomes such as locoregional recurrence, disease free survival and overall survival. Surgeons will also rate the aesthetic outcomes for their own patients, and these will be compared with the ratings provided by a blinded breast surgeon. Read more
Previous research projects Breast reconstruction and radiotherapy for breast cancer
This study was a retrospective observational study of women with breast cancer who had mastectomy, immediate breast reconstruction with implants and post-mastectomy radiotherapy. It involved surveying women six months after their final breast reconstruction operation about their satisfaction with the aesthetic outcomes of their surgery, and its effect on their psychological wellbeing and quality of life. These patient-reported outcomes were assessed alongside measures of their clinical outcomes including post-operative or post-radiotherapy complications. A subset of these women also had a clinical examination and photos taken at six months following their final reconstruction procedure and these were reviewed by an independent surgeon. Read more
Survivorship care planning in breast cancer
In the months and years that follow treatment for breast cancer, many women have ongoing issues related to cancer and treatment. These are often not well addressed with usual follow-up care and it is thought that a survivorship care plan may help to improve care. A survivorship care plan is a written plan for long-term care that is developed by a woman and her team of specialists at the end of cancer treatment. This project developed a Care Plan booklet that contains personalised information about cancer treatment and follow-up visits and also has general information about life after breast cancer. Seventy women treated for breast cancer at our centre worked with their specialists to develop a Care Plan and this was evaluated over an 18-month period. The final results have been published. The results showed a high level of satisfaction in women who had a Care Plan although there was no measurable benefit to quality of life. Abstract. Several papers relating to this project and survivorship care have been published by our group. Read Publication Highlights
Developing new surgical techniques in melanoma and breast cancer
- Minimal access breast surgery (MABS)
Minimal access breast surgery (MABS) is a surgical technique that uses only one incision for breast conservation surgery (wide local excision) and sentinel lymph node biopsy. Traditional surgical techniques would use two or three incisions (on the breast, in the armpit and sometimes in the sternal area) in order to remove the breast cancer and sample all of the sentinel lymph nodes. A/Prof Andrew Spillane is the first surgeon in the world to describe the single-incision technique. He uses this routinely in almost all of his breast conservation operations, with superior cosmesis and comfort for the patient and equivalent oncological results. Read abstract
- Minimal access ilioinguinal dissection for melanoma
A modified procedure for ilio-inguinal regional lymph node dissection involving 2 small skin incisions was evaluated with the aim of assessing surgical and oncological outcomes compared with the traditional single, much longer, longitudinal groin incision. Read abstract
Thermography
A systematic review of the published literature showed that digital infrared thermographic imaging is unreliable as a breast imaging modality.
Internal mammary sentinel lymph node biopsy and lymphoscintigraphy for breast cancer
A/Prof Spillane and Dr Farnoush Noushi in combination with Prof Roger Uren have published several papers about the role of intermal mammary sentinel lymph node biopsy in breast cancer. This includes an original study comparing two different injection techniques for lymphoscinitgraphy (a nuclear medicine study that maps the lymphatic drainage from a breast cancer to the sentinel lymph nodes).
