Please use this identifier to cite or link to this item: http://hdl.handle.net/2381/43893
Title: The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study.
Authors: O'Connell, RL
Rattay, T
Dave, RV
Trickey, A
Skillman, J
Barnes, NLP
Gardiner, M
Harnett, A
Potter, S
Holcombe, C
iBRA-2 Steering Group
Breast Reconstruction Research Collaborative
First Published: 29-Mar-2019
Publisher: Springer Nature, Cancer Research UK
Citation: British Journal of Cancer, 2019. 120, pp. 883–895
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.
DOI Link: 10.1038/s41416-019-0438-1
eISSN: 1532-1827
Links: https://www.nature.com/articles/s41416-019-0438-1
http://hdl.handle.net/2381/43893
Embargo on file until: 29-Sep-2019
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2019, Springer Nature, Cancer Research UK. Deposited with reference to the publisher’s open access archiving policy. (http://www.rioxx.net/licenses/all-rights-reserved)
Description: The file associated with this record is under embargo until 6 months after publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.
Appears in Collections:Published Articles, Dept. of Cancer Studies and Molecular Medicine

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