The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

O’Connell, Rachel L. and Rattay, Tim and Dave, Rajiv V. and Trickey, Adam and Skillman, Joanna and Barnes, Nicola L. P. and Gardiner, Matthew and Harnett, Adrian and Potter, Shelley and Holcombe, Chris and iBRA-2 Steering Group and Breast Reconstruction Research Collaborative and Malata, Charles M. (2019) The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study. British Journal of Cancer, 120 (9). pp. 883-895. ISSN 1532-1827

[img]
Preview
Text
Published Version
Available under the following license: Creative Commons Attribution.

Download (466kB) | Preview
Official URL: https://doi.org/10.1038/s41416-019-0438-1

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Item Type: Journal Article
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Lisa Blanshard
Date Deposited: 27 May 2020 10:19
Last Modified: 09 Sep 2021 18:55
URI: https://arro.anglia.ac.uk/id/eprint/705567

Actions (login required)

Edit Item Edit Item