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- Title
The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study.
- Authors
O'Connell, Rachel L; Rattay, Tim; Dave, Rajiv V; Trickey, Adam; Skillman, Joanna; Barnes, Nicola L P; Gardiner, Matthew; Harnett, Adrian; Potter, Shelley; Holcombe, Chris; iBRA-2 Steering Group; Breast Reconstruction Research Collaborative
- Abstract
<bold>Background: </bold>Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy.<bold>Methods: </bold>Consecutive women undergoing mastectomy ± IBR for breast cancer July-December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored.<bold>Results: </bold>A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays.<bold>Conclusions: </bold>IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients.
- Publication
British Journal of Cancer, 2019, Vol 120, Issue 7, p883
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-019-0438-1