Fast-track Non-urgent Tertiary Total number 452 520 26 Age range (median) 14-95 (45) 13-86 (39) 18-90 (54) Cancer (percent of group total) 54 (11.94%) 3 (0.57%) 6 (23.07%) Benign pathologies Total 158 126 11 Fibroadenoma 30 25 0 Cysts 64 48 1 Lipomas 16 7 0 Others 48 46 10 Mastalgia only 223 364 8 Gynecomastia 17 27 1 95.23 % of all cancer diagnoses (60 out of 63) were seen within two weeks as fast-track or tertiary referrals. This was significantly more (p < 0.05) than the number of cancers diagnosed in non-urgent group (3 patients). Conclusions: General practitioners are currently appropriately refer- ring to urgent and non-urgent clinic slots. The new target will offer no ad- vantage to cancer patients but will increase pressure on existing services. It can potentially compromise diagnostic accuracy unless the service is fully and appropriately resourced. P67. Impact of clear margins invasive breast cancer on local recurrence in breast conserving surgery. Jasim Almosawi, H. Hamed, H. Garmo, I. Fentiman Guys Hospital, Thomas Guy House, London, SE1 9RT Introduction: Microscopically clear margins are necessary to mini- mize the likelihood of breast relapse in breast conserving surgery (BCS).Several factors have been identified to associate with margin in- volvement after BCS. It is assumed that reexcision to achieve clear mar- gins is as effective as complete tumour removal at a single procedure, however, the efficacy of reexcision in this context has not been well studied. Method: A retrospective study of Hedley Atkins unit, Guy’s Hospital identified 431 who underwent BCS from 1995 to 1999.Several variables were analysed using S-Plus version 6.2 and variables were compared by both Pearson Chi- squared and Fishers exact probability test to assess which variables to include in logistic regression. Results: Margin involvement were found in 308 out of 431 (71%), group B and negative in 123 (29%), group A.161 of group B underwent re-excision, and 147 had no re-excision. After re-excision 88 out of 161 (54.7%) had no residual tumour, while 45.3% were positive.The later group subdivided into those which become clear after reexcision, and those remained involved.The significant factors of margin involvement were age, maximum dimension of wide excision, tumour size menopausal status, tu- mour type vascular invasion, nature (focal or extensive) and sort (at the margin or narrowly excised) of involvement. Local recurrence was 3.6% in groups achieved negative margins,12% when margins remained positive after reexcision and 5.7% (group D) when no re-excision done. Conclusion: Our finding confirm the 2 mm margin is safe and histolog- ically clear margin is essential to decrease the risk of local recurrence. P68. Role of axillary ultrasound in defining surgical management of breast cancer patients with nodal disease Abdul Syed, M. Garbos, A. Patel, S. Jenkins, H. Bradpiece The Princess Alexandra Hospital NHS Trust, Hamstel Road, Harlow, Essex, CM20 1QX Introduction: With the introduction of SLNB, breast cancer patients with nodal disease had to undergo second surgery. The aim of our study was to correlate the accuracy of ultrasound in redefining surgery in these patients. Methods: The records of all breast cancer patients who underwent Ax- illary Lymph Node Dissection (ALND) from January 2008 to December 2008 were reviewed. Of these, patients who had pre operative axillary ul- trasound and or FNAC were included. Ultrasound and or FNA findings were compared with final histology. Results: Of the 181 patients with ALND, only seventy five patients had axillary ultrasound. Twenty five patients (32.3%) had abnormal ultra- sound findings. Of these, 22 patients had positive surgical staging and three were negative. Ten of the abnormal axilla had FNAC done. Of these, seven patients had metastatic cells and all proven to be positive. Of the fifty pa- tients with normal axilla, 34 patients had negative surgical staging and 16 were positive. The sensitivity of ultrasound axilla was 57.89%; specificity 96%; Positive predictive value 88% and Negative predictive value was 78.57%. However the overall accuracy reaches 100% with FNAC. Discussion: Axillary ultrasound with needle cytology is a safe and fast method of assessing the lymph nodal status. The results of our study are mostly in agreement with previous published studies. By increasing the number of patients for axillary ultrasound and FNAC, second axillary sur- gery could be spared in many patients. This will avoid long term sequelae of two axillary surgeries as well as save financial resources and time. P69. Characterisation of P-Cadherin in invasive breast cancer: an immunohistochemical and functional study Preethi Gopinath a , S. Clark b , L. Jones b , F. Mihaimeed a a Newham University Hospital NHS Trust, Glen Road, Plaistow, London, E13 8SL b Tumour Biology, Institute of Cancer, Queen Mary University of London Aim: P-cadherin is a 118 kDa cell-cell adhesion glycoprotein. Overex- pression of P-cadherin has been associated with invasive breast cancer, particularly with worsening histological grade. This study aimed to analyse a series of invasive ductal carcinomas to characterise P-cadherin and func- tional analyses of P-cadherin using breast cancer cell lines. Methods: A series of 135 invasive breast cancers was used to evaluate the immunohistochemical expression of P-cadherin. Five breast cancer cell lines and one normal myoepithelial breast cell line were used for immuno- fluorescence studies and invasion assays to characterise the functional role of P-cadherin in breast cancer. Results: 80.7% of this series were P-cadherin positive (109/135) which had positive correlation with ER status (103/135) and negative correlation with PR status (77/135). Increasing histological grade was linked with P- cadherin expression (p ¼ 0.003). Of the P-cadherin positive cases, 76% (83/109) were ER positive, 57% (63/109) were PR positive, 67% had neg- ative LN status and no significant relationship to tumour size. Gi101 and MDA-MB-468 breast cancer cell lines expressed membranous P-cadherin on immunofluorescence; MCF-7 cell line showed cytoplasmic expression and T47D cell line had borderline expression. Initial data from knock- down in-vitro studies indicates invasion modulation through alteration of P-cadherin expression. Conclusion: This study confirms existing findings regarding correla- tions with tumour grade and estrogen expression. Further knock-down and over-expression studies would increase understanding of the role of P-cadherin in invasion and migration. This data with previous research findings indicate that P-cadherin has significant prognostic significance and has the potential to influence treatment strategies. P70. An audit of physical activity levels in Glasgow breast clinics. Alfred Tan a , E. Pavlidou a , K. Ogston a , J. Doughty b , A. Campbell c , S. Tovey a a Section of Surgery, Division of Cancer Sciences and Molecular Pathology, Queen Elizabeth Building Level 2, Glasgow Royal Infirmary, Glasgow, G4 0SF b Western Infirmary Glasgow c University of Strathclyde, Glasgow Introduction: Epidemiological studies suggest that moderate intensity recreational physical activity (PA) improves breast cancer survival. We ABSTRACTS 1223