complete or near complete imaging response on ultrasound scan +/- mammogram. They must have also demonstrated a pCR on post-NACT VACB following a standardized protocol. These women will not undergo breast and axillary surgery following completion of NACT but will receive radiotherapy and will continue systemic treatments as indicated. The primary endpoint of the study is the biopsy proven ipsilateral breast tumour recurrence free survival at 5 years. Results will provide data that might support a paradigm change in the treatment of breast cancer. P125. CLINICAL MANAGEMENT OF BREAST PATIENTS WITH PROVEN BRCA1, BRCA2 OR TP53 MUTATION IN NHS TAYSIDE Pavithran Maniam 1 , Jonathan Berg 2 , E.Jane Macaskill 3 , Beatrix Elsberger 4 . 1 School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom; 2 Clinical Genetics, Ninewells Hospital & Medical School, University of Dundee, Dundee, United Kingdom; 3 Department of Breast Surgery Ninewells Hospital and Medical School, Dundee, United Kingdom; 4 Department of Breast Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom Background: Approximately 5-10% of all breast cancers are hereditary, of which 20-25% are associated with a mutation in either BRCA1, BRCA2 or TP53 gene. Despite the availability of national guidelines, the clinical management of mutation carriers in Tayside was unclear. This study aimed to establish the clinical management of mutation carriers and contribute to service improvement. Methods: Caldicott’s approval was granted and the clinical details were collected retrospectively from 2007 to 2017. The current clinical practice was compared to the national SIGN and NICE guidelines. Results: 299 female mutation carriers (119 BRCA1, 179 BRCA2 and 1 TP53) were identified in Tayside. The mean age was 48.6 years (range 18-87). Mutation carriers were referred following a diagnosis of cancer (45.1%) or through cascade genetic testing (45.6%). During genetic counselling, sur- veillance screening was discussed with the majority of mutation carriers (n¼161, 78.9%). 132 (64.7%) individuals opted for routine imaging sur- veillance (mammogram and/or MRI). Risk-reducing surgery was discussed with 172 (84.3%) mutation carriers and 120 (58.5%) individuals opted for risk-reducing breast and/or gynaecology surgeries. However, chemopre- vention was discussed with just 8 (3.9%) mutation carriers and only 2 in- dividuals commenced chemoprevention. Conclusion: These findings prompted our services to review the clinical management pathway of newly diagnosed mutation carriers. In collabo- ration with our clinical genetics colleagues, the method of discussion and delivery of all prevention methods is being worked on. Developing written booklets as aides would provide guidance for counsellors, but also suffi- cient information for patients to make informed decisions regarding their cancer prevention. P126. IMPACT OF SINGLE USE NEGATIVE PRESSURE WOUND THERAPY ON SURGICAL INCISIONS FOLLOWING BREAST SURGERY: A MULTI- CENTRE EVALUATION Shona Tormey 1 , Helen Mathers 2 , Samantha Sloan 3 , Tim Styche 4 , Catherine Whittall 5 . 1 University Hospital Limerick, Co, Limerick, Ireland; 2 Craigavon Area Hospital, Craigavon, Ireland; 3 Belfast City Hospital, Belfast, Ireland; 4 Smith & Nephew, Hull, United Kingdom; 5 Smith & Nephew, Watford, United Kingdom Introduction: The aim of this evaluation was to determine the impact of single-use negative pressure wound therapy (sNPWT) dressings when used prophylactically on patients considered high-risk for wound healing, undergoing therapeutic breast surgery. A service evaluation was initiated with hospitals currently using sNPWT within their breast surgery unit with an aim of determining the impact of sNPWT within a real world setting. Method: Data were collected between December 2016 and August 2018 from three hospitals. A baseline sample of 66 patients were documented at discharge and follow up to ascertain the current base rate of complications following breast surgery within the hospitals. The outcomes of a further 66 patients, treated with sNPWT, were documented in identical fashion and comparisons were made between the cohorts. Results: The use of sNPWT reduced the number of deep surgical site in- fections (SSIs) from three in the non-sNPWT group to zero in the sNPWT group. Similarly, superficial SSIs were reduced from 9/66 to 2/66. Overall, the use of sNPWT reduced SSI incidence by 75%. The combined data shows an estimated total cost reduction from £22,896 to £13,479, an estimated saving of £9,417. Conclusion: The results of this evaluation complement the current evi- dence for sNPWT following breast surgery, and highlights the potential impact when implemented into clinical practice, by use of a pre-deter- mined pathway for application on high-risk patients. It also demonstrates the reduction in wound complications as a direct result of prophylactic sNPWT and the potential for cost-savings to a hospital. P127. IMPACT OF ONCOTYPE DX TEST ON THE USE OF ADJUVANT CHEMOTHERAPY IN EARLY BREAST CANCER OVER 5 YEARS IN OXFORD, UK Akriti Nanda 1 , Pankaj Roy 2,1 , Nicky Levitt 2 , Sileida Oliveros 2 , Bernadette Lavery 2 , Ben Phillips 2 , Laura Mustata 2 . 1 University of Oxford, Oxford, United Kingdom; 2 Oxford University Hospitals, Oxford, United Kingdom Introduction: The decision for adjuvant chemotherapy in breast cancer is traditionally based on clinico-pathological factors; about 34% receive it with potential short and long-term side-effects. Oncotype Dx, gene expression profiling assay, is now used for patients with ER+, HER2-, LN-ve cancers to predict chemotherapy benefit as recommended by NICE (2013). Our MDT has been using it regularly since then and has also extended the indication for highly-selected node-positive patients. We evaluated the impact of Oncotype-DX usage on treatment recommendations over 5 years (2013-2018). Methods: Onctoype DX was carried out on 146 women with ER+, HER2-, invasive breast cancer who underwent primary surgery. The treatment recommendations were noted in the MDT and then compared to the de- cision after DX testing. The impact on treatment decisions and associated cost impact were assessed. Results: In the LN negative group (n¼77); 43 were recommended to have chemotherapy and hormone-therapy and 34 hormone-therapy only. The RS (recurrence score) allowed 24 women (58%) to avoid unnecessary chemotherapy and discovered 9 (26%) to benefit from chemotherapy. In the LN positive group (n¼62); all were recommended chemotherapy; RS allowed 52 women (85%) to avoid it. The costs involved were compared using standard chemotherapy cost without taking into consideration the cost incurred by the hospital to manage chemotherapy complications. Conclusions: Incorporating Oncotype testing into clinical practice for node-negative and highly-selected node-positive patients, predicted to derive intermediate benefit, has reduced chemotherapy use. No negative impact has been observed so far by omission of chemotherapy. P128. REDUCING THE BURDEN OF RESEARCH: A FEASIBILITY STUDY OF A NOVEL ONLINE STUDY DESIGN FOR USE IN A MULTI-CENTRE STUDY Amy R. Godden 1, 2 , Aikaterini Micha 1 , Carol Pitches 1 , Peter A. Barry 1 , Katherine D.C. Krupa 1 , Jennifer E. Rusby 1, 2 . 1 Royal Marsden NHS Foundation Trust, Sutton, United Kingdom; 2 Institute of Cancer Research, London, United Kingdom Introduction: Participation in research is beneficial for patients and healthcare providers. Research can prove demanding at patient, clinician and trust level. Patient representatives are supportive of online research to overcome these challenges. We describe results from a pilot study assessing feasibility and acceptability of a novel online recruitment method, and the accuracy of patient-reported data collection. Methods: REC approved pilot study. A bespoke website was developed in a ‘one-day-hackathon’ with a website design company. 100 women who underwent implant-based breast reconstruction from 2011-2016 were invited by letter containing the URL and a unique study ID. Once partici- pants had completed the online consent process, access to online data entry pages (demographics, height, weight, treatment received and BREAST-Q) was granted. One hospital visit was required for a 3D surface image, also booked online. We performed real-time process evaluation. Results: Recruitment rate was 30%. Of these, 79% completed the online Abstracts / European Journal of Surgical Oncology 45 (2019) 886e926 917