TY - JOUR
T1 - The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study
AU - the Breast Reconstruction Research Collaborative
AU - on behalf of the iBRA-2 Steering Group
AU - O’Connell, Rachel L.
AU - Rattay, Tim
AU - Dave, Rajiv V.
AU - Trickey, Adam
AU - Skillman, Joanna
AU - Barnes, Nicola L.P.
AU - Gardiner, Matthew
AU - Harnett, Adrian
AU - Potter, Shelley
AU - Holcombe, Chris
AU - Blazeby, Jane
AU - Conroy, Elizabeth
AU - O’Brien, Ciara
AU - O’Connell, Rachel
AU - Potter, Shelley
AU - Williamson, Paula
AU - Curnier, Alain
AU - Tadros, Amir
AU - Depasquale, Ivan
AU - Masannat, Yazan A.
AU - Smyth, Elizabeth
AU - Fuller, Mairi
AU - Bourne, Roger
AU - Heys, Steven
AU - Hamo, Ishrak
AU - Aloraifi, Fatima
AU - Fopp, Laura
AU - Bali, Radhika
AU - Bache, Sarah
AU - Benyon, Sarah L.
AU - Irwin, Michael S.
AU - Agrawal, Amit
AU - Malata, Charles M.
AU - Murphy, Claire
AU - Misky, Adam
AU - Chicken, Dennis Wayne
AU - Abdullah, Nassreen
AU - Irwin, Gareth
AU - McIntosh, Stuart A.
PY - 2019/4/30
Y1 - 2019/4/30
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85063751400&partnerID=8YFLogxK
U2 - 10.1038/s41416-019-0438-1
DO - 10.1038/s41416-019-0438-1
M3 - Article
C2 - 30923359
AN - SCOPUS:85063751400
VL - 120
SP - 883
EP - 895
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
IS - 9
ER -