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

iBRA-2 Steering Group; Breast Reconstruction Research Collaborative

doi:10.1038/s41416-019-0438-1

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

iBRA-2 Steering Group, Breast Reconstruction Research Collaborative

Health Services Research Unit (HSRU)

Research output: Contribution to journal › Article › peer-review

40 Citations (Scopus)

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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.

Original language	English
Pages (from-to)	883-895
Number of pages	13
Journal	British Journal of Cancer
Volume	120
DOIs	https://doi.org/10.1038/s41416-019-0438-1
Publication status	Published - 29 Mar 2019

Bibliographical note

The datasets generated during and/or analysed during the current study are not publicly available due to ongoing analyses but are available from the corresponding author on reasonable request.

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The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy
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Cite this

@article{10a20699e65042bd94b3b562692f23d8,

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

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.",

author = "O'Connell, {Rachel L} and Tim Rattay and Dave, {Rajiv V} and Adam Trickey and Joanna Skillman and Barnes, {Nicola L P} and Matthew Gardiner and Adrian Harnett and Shelley Potter and Chris Holcombe and Yazan Masannat and {iBRA-2 Steering Group} and {Breast Reconstruction Research Collaborative}",

note = "The datasets generated during and/or analysed during the current study are not publicly available due to ongoing analyses but are available from the corresponding author on reasonable request. ",

year = "2019",

month = mar,

day = "29",

doi = "10.1038/s41416-019-0438-1",

language = "English",

volume = "120",

pages = "883--895",

journal = "British Journal of Cancer",

issn = "0007-0920",

publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy

T2 - the iBRA-2 study

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 - Masannat, Yazan

AU - iBRA-2 Steering Group

AU - Breast Reconstruction Research Collaborative

N1 - The datasets generated during and/or analysed during the current study are not publicly available due to ongoing analyses but are available from the corresponding author on reasonable request.

PY - 2019/3/29

Y1 - 2019/3/29

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.

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UR - http://www.mendeley.com/research/impact-immediate-breast-reconstruction-time-delivery-adjuvant-therapy-ibra2-study

U2 - 10.1038/s41416-019-0438-1

DO - 10.1038/s41416-019-0438-1

M3 - Article

C2 - 30923359

SN - 0007-0920

VL - 120

SP - 883

EP - 895

JO - British Journal of Cancer

JF - British Journal of Cancer

ER -

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

Abstract

Bibliographical note

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