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Abstract
Background:
Breast augmentation is the most commonly performed cosmetic procedure, and increasingly women in this group present with breast cancer or request risk-reducing surgery, but their optimal management is unclear. The authors explored the clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction following previous augmentation and compared these with outcomes of patients who had not had cosmetic implants in the Implant Breast Reconstruction Evaluation (iBRA) Study.
Methods:
Patients undergoing immediate implant-based breast reconstruction were prospectively recruited from breast and plastic surgical units across the United Kingdom. Demographic, operative, and oncologic data, and information regarding complications within 3 postoperative months were collected. Patient-reported outcomes at 18 months were assessed using the BREAST-Q. The clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction with and without previous breast augmentation were compared.
Results:
A total of 2108 women were included in the iBRA Study, of whom 49 had undergone a previous augmentation. Women in the augmentation group were younger (median age, 45 years versus 50 years; p = 0.01), had a lower body mass index (22.8 kg/m2 versus 24.9 kg/m2; p < 0.01), and had smaller tumors (15 mm versus 25 mm; p = 0.01) than patients without augmentation. No differences were seen in operative technique between the groups. Complications at 3 months were similar in both groups and there were no significant differences in patient-reported outcomes at 18 months.
Conclusions:
The clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction following previous augmentation are consistent with those observed in the wider iBRA Study cohort, supporting the safety of this approach.
Breast augmentation is the most commonly performed cosmetic procedure, and increasingly women in this group present with breast cancer or request risk-reducing surgery, but their optimal management is unclear. The authors explored the clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction following previous augmentation and compared these with outcomes of patients who had not had cosmetic implants in the Implant Breast Reconstruction Evaluation (iBRA) Study.
Methods:
Patients undergoing immediate implant-based breast reconstruction were prospectively recruited from breast and plastic surgical units across the United Kingdom. Demographic, operative, and oncologic data, and information regarding complications within 3 postoperative months were collected. Patient-reported outcomes at 18 months were assessed using the BREAST-Q. The clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction with and without previous breast augmentation were compared.
Results:
A total of 2108 women were included in the iBRA Study, of whom 49 had undergone a previous augmentation. Women in the augmentation group were younger (median age, 45 years versus 50 years; p = 0.01), had a lower body mass index (22.8 kg/m2 versus 24.9 kg/m2; p < 0.01), and had smaller tumors (15 mm versus 25 mm; p = 0.01) than patients without augmentation. No differences were seen in operative technique between the groups. Complications at 3 months were similar in both groups and there were no significant differences in patient-reported outcomes at 18 months.
Conclusions:
The clinical and patient-reported outcomes of patients undergoing immediate implant-based breast reconstruction following previous augmentation are consistent with those observed in the wider iBRA Study cohort, supporting the safety of this approach.
| Original language | English |
|---|---|
| Pages (from-to) | 324-337 |
| Number of pages | 14 |
| Journal | Plastic and Reconstructive Surgery |
| Volume | 149 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1 Feb 2022 |
Bibliographical note
Funding Information:This work was funded by a National Institute for Health Research, Research for Patient Benefit Programme grant (PB-PG-0214-33065); pump-priming funding from the Association of Breast Surgery and the British Association of Plastic Reconstructive and Aesthetic Surgeons; and a Research Development Award from the Association of Breast Surgery (2019). Shelley Potter, Ph.D., F.H.E.A., F.R.C.S., N.I.H.R., is a National Institute for Health Research Clinician Scientist (CS-2016-16-019). This work was undertaken with the support of the Medical Research Council ConDuCT-II (Collaboration and innovation for Difficult and Complex randomized controlled Trials In Invasive procedures) Hub for Trials Methodology Research (MR/K025643/1) and the National Institute for Health Research Biomedical Research Centre at University Hospitals Bristol National Health Service Foundation Trust and the University of Bristol.
Publisher Copyright:
Copyright © 2022 by the American Society of Plastic Surgeons.
Fingerprint
Dive into the research topics of 'Implant-Based Reconstruction following Mastectomy in Patients Who Have Had a Previous Breast Augmentation: Lessons from the National Multicenter Implant Breast Reconstruction Evaluation Study'. Together they form a unique fingerprint.Research output
- 1 Citations
- 5 Article (Academic Journal)
-
Patient-reported outcomes of immediate implant-based breast reconstruction with and without biological or synthetic mesh
Sewart, E., Turner, N. L., Conroy, E., Cutress, R., Skillman, J., Whisker, L., Thrush, S., Barnes, N., Holcombe, C., Potter, S. & the iBRA Steering Group and the Breast Reconstruction Research Collaborative, 20 Feb 2021, In: BJS Open. 5, 1, 12 p., zraa063.Research output: Contribution to journal › Article (Academic Journal) › peer-review
Open AccessFile26 Citations (Scopus)127 Downloads (Pure) -
The impact of radiotherapy on patient-reported outcomes of immediate implant-based breast reconstruction with and without mesh
Sewart, E., Turner, N. L., Conroy, E., Cutress, R., Skillman, J., Whisker, L., Thrush, S., Barnes, N., Holcombe, C., Potter, S. & the iBRA Steering Group and the Breast Reconstruction Research Collaborative, 9 Jul 2020, In: Annals of Surgery. 0, p. 1-10 10 p.Research output: Contribution to journal › Article (Academic Journal) › peer-review
Open AccessFile12 Citations (Scopus)162 Downloads (Pure) -
Short-term safety outcomes of mastectomy and immediate implant-based breast reconstruction with and without mesh (iBRA): a multicentre, prospective cohort study
Potter, S., Conroy, E., Cutress, R., Williamson, P., Whisker, L., Thrush, S., Skillman, J., Barnes, N., Mylvaganam, S., Teasdale, E., Jain, A., Gardiner, M., Blazeby, J., Holcombe, C. & the iBRA Steering Group and the Breast Reconstruction Research Collaborative, 1 Feb 2019, In: Lancet Oncology. 20, 2, p. 254-266 13 p.Research output: Contribution to journal › Article (Academic Journal) › peer-review
Open AccessFile170 Citations (Scopus)152 Downloads (Pure)
Projects
- 3 Finished
-
IB 8072 Association of Breast Surgery: Informing best practice in immediate implant-based breast reconstruction: Further analysis of the iBRA study cohort
Potter, S. (Principal Investigator)
1/07/19 → 30/09/22
Project: Research
-
The BRAVER Study - Methods to develop less and better research in reconstructive breast surgery
Potter, S. (Principal Investigator)
1/03/17 → 31/08/23
Project: Research
-
NIHR RfPB via UH Bristol: 'The iBRA (implant Breast Reconstruction evAluation) study - A prospective multicentre cohort study to inform the feasibility and conduct a pragmatic randomised clinical trial comparing new techniques of implant-based breast reco
Potter, S. (Principal Investigator)
1/06/15 → 31/05/18
Project: Research, Parent