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6. Bridging pre-surgical endocrine therapy for breast cancer during the COVID-19 pandemic: outcomes from the B-MaP-C study

Author

Dave, Rajiv V., Elsberger, Beatrix, Taxiarchi, Vicky P., Gandhi, Ashu, Kirwan, Cliona C., Kim, Baek, Camacho, Elizabeth M., Coles, Charlotte E., Copson, Ellen, Courtney, Alona, Horgan, Kieran, Fairbrother, Patricia, Holcombe, Chris, Kirkham, Jamie J., Leff, Daniel R., McIntosh, Stuart A., O’Connell, Rachel, Pardo, Ricardo, Potter, Shelley, Rattay, Tim, Sharma, Nisha, Vidya, Raghavan, and Cutress, Ramsey I.

Published
2023
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10. Uncertainties and controversies in axillary management of patients with breast cancer

Author

Weber, Walter P, Davide Gentilini, Oreste, Morrow, Monica, Montagna, Giacomo, de Boniface, Jana, Fitzal, Florian, Wyld, Lynda, Rubio, Isabel T., Matrai, Zoltan, King, Tari A., Saccilotto, Ramon, Galimberti, Viviana, Maggi, Nadia, Andreozzi, Mariacarla, Sacchini, Virgilio, Castrezana López, Liliana, Loesch, Julie, Schwab, Fabienne D., Eller, Ruth, Heidinger, Martin, Haug, Martin, Kurzeder, Christian, Di Micco, Rosa, Banys-Paluchowski, Maggie, Ditsch, Nina, Harder, Yves, Paulinelli, Régis R., Urban, Cicero, Benson, John, Bjelic-Radisic, Vesna, Potter, Shelley, Knauer, Michael, Thill, Marc, Vrancken Peeters, Marie-Jeanne, Kuemmel, Sherko, Heil, Joerg, Gulluoglu, Bahadir M., Tausch, Christoph, Ganz-Blaettler, Ursula, Shaw, Jane, Dubsky, Peter, Poortmans, Philip, Kaidar-Person, Orit, Kühn, Thorsten, and Gnant, Michael

Published
2023
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12. Oncoplastic breast consortium recommendations for mastectomy and whole breast reconstruction in the setting of post-mastectomy radiation therapy

Author

Weber, Walter Paul, Shaw, Jane, Pusic, Andrea, Wyld, Lynda, Morrow, Monica, King, Tari, Mátrai, Zoltán, Heil, Jörg, Fitzal, Florian, Potter, Shelley, Rubio, Isabel T., Cardoso, Maria-Joao, Gentilini, Oreste Davide, Galimberti, Viviana, Sacchini, Virgilio, Rutgers, Emiel J.T., Benson, John, Allweis, Tanir M., Haug, Martin, Paulinelli, Regis R., Kovacs, Tibor, Harder, Yves, Gulluoglu, Bahadir M., Gonzalez, Eduardo, Faridi, Andree, Elder, Elisabeth, Dubsky, Peter, Blohmer, Jens-Uwe, Bjelic-Radisic, Vesna, Barry, Mitchel, Hay, Susanne Dieroff, Bowles, Kimberly, French, James, Reitsamer, Roland, Koller, Rupert, Schrenk, Peter, Kauer-Dorner, Daniela, Biazus, Jorge, Brenelli, Fabricio, Letzkus, Jaime, Saccilotto, Ramon, Joukainen, Sarianna, Kauhanen, Susanna, Karhunen-Enckell, Ulla, Hoffmann, Juergen, Kneser, Ulrich, Kühn, Thorsten, Kontos, Michalis, Tampaki, Ekaterini Christina, Carmon, Moshe, Hadar, Tal, Catanuto, Giuseppe, Garcia-Etienne, Carlos A., Koppert, Linetta, Gouveia, Pedro F., Lagergren, Jakob, Svensjö, Tor, Maggi, Nadia, Kappos, Elisabeth A., Schwab, Fabienne D., Castrezana, Liliana, Steffens, Daniel, Krol, Janna, Tausch, Christoph, Günthert, Andreas, Knauer, Michael, Katapodi, Maria C., Bucher, Susanne, Hauser, Nik, Kurzeder, Christian, Mucklow, Rosine, Tsoutsou, Pelagia G., Sezer, Atakan, Çakmak, Güldeniz Karadeniz, Karanlik, Hasan, Fairbrother, Patricia, Romics, Laszlo, Montagna, Giacomo, Urban, Cicero, Walker, Melanie, Formenti, Silvia C., Gruber, Guenther, Zimmermann, Frank, Zwahlen, Daniel Rudolf, Kuemmel, Sherko, El-Tamer, Mahmoud, Vrancken Peeters, Marie Jeanne, Kaidar-Person, Orit, Gnant, Michael, Poortmans, Philip, and de Boniface, Jana

Published
2022
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13. Should Acellular Dermal Matrices Be Used for Implant-based Breast Reconstruction after Mastectomy? Clinical Recommendation Based on the GRADE Approach

Author

Michela Cinquini, PhD, Nicola Rocco, MD, PhD, Giuseppe Catanuto, MD, PhD, Emanuele Garreffa, MD, Pietro Maria Ferrando, MD, Marien Gonzalez-Lorenzo, PhD, Anna Maglia, PhD, Giacomo Montagna, MD, Amedeo Villanucci, MD, Valentina Visintini Cividin, MD, Maurizio Bruno Nava, MD, GRADE MBN 2021 Collaborative Group, Agrawal Amit, Andree Cristoph, Awaad Samir Abdel Fattah, Barnea Yoav, Brown Mitchell, Cagli Barbara, Castagnetti Fabio, Celet Ozden Burcu, Chatterjee Abhishek, Criscitiello Carmen, De Vita Roy, Dietz Jill, Falco Giuseppe, Gonzalez Eduardo, Gulluoglu Bahadir, Harder Yves, Karp Nolan, Kovacs Tibor, Masannat Yazan, Michieletto Silvia, Meani Francesco, Meattini Icro, Moreira Andrea, Nafissi Nahid, Nahabedian Maurice, Paulinelli Regis, Potter Shelley, Poulakaki Fiorita, Rancati Alberto, Saibene Tania, Salgarello Marzia, Sallam Ibrahim Mohammed, Svanhediur Rafnsdtottir, Tasoulis Marios, Urban Cicero, Weber Walter, and Youssef Mina

Subjects
Surgery, RD1-811
Abstract

Background:. Acellular dermal matrices (ADMs) entered the market in the early 2000s and their use has increased thereafter. Several retrospective cohort studies and single surgeon series reported benefits with the use of ADMs. However, robust evidence supporting these advantages is lacking. There is the need to define the role for ADMs in implant-based breast reconstruction (IBBR) after mastectomy. Methods:. A panel of world-renowned breast specialists was convened to evaluate evidence, express personal viewpoints, and establish recommendation for the use of ADMs for subpectoral one-/two-stage IBBR (compared with no ADM use) for adult women undergoing mastectomy for breast cancer treatment or risk reduction using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Results:. Based on the voting outcome, the following recommendation emerged as a consensus statement: the panel members suggest subpectoral one- or two-stage IBBR either with ADMs or without ADMs for adult women undergoing mastectomy for breast cancer treatment or risk reduction (with very low certainty of evidence). Conclusions:. The systematic review has revealed a very low certainty of evidence for most of the important outcomes in ADM-assisted IBBR and the absence of standard tools for evaluating clinical outcomes. Forty-five percent of panel members expressed a conditional recommendation either in favor of or against the use of ADMs in subpectoral one- or two-stages IBBR for adult women undergoing mastectomy for breast cancer treatment or risk reduction. Future subgroup analyses could help identify relevant clinical and pathological factors to select patients for whom one technique could be preferable to another.

Published
2023
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14. Knowledge gaps in oncoplastic breast surgery

Author

González, Eduardo, Elzayat, Mona, Koller, Rupert, Gnant, Michael, Brenelli, Fabricio, Paulinelli, Regis Resende, Zobel, Vappu, Joukainen, Sarianna, Karhunen-Enckell, Ulla, Kauhanen, Susanna, Piat, Jean-Marc, Bjelic-Radisic, Vesna, Faridi, Andree, Heitmann, Christoph, Hoffmann, Juergen, Kneser, Ulrich, Kümmel, Sherko, Kühn, Thorsten, Kontos, Michalis, Tampaki, Ekaterini Christina, Barry, Mitchel, Allweis, Tanir M, Carmon, Moshe, Hadar, Tal, Catanuto, Giuseppe, Garcia-Etienne, Carlos A, Gentilini, Oreste D, Knox, Susan, Klein, Barbara, Koppert, Linetta, Gouveia, Pedro F, Svensjö, Tor, Bucher, Heiner C, Ess, Silvia, Ganz-Blättler, Ursula, Günthert, Andreas, Hauser, Nik, Hynes, Nancy, Knauer, Michael, Pfeiffer, Marlen, Rochlitz, Christoph, Tausch, Christoph, Harder, Yves, Zimmermann, Frank, Schwab, Fabienne D, D'Amico, Veronica, Soysal, Savas D, Castrezana Lopez, Liliana, Fulco, Ilario, Hemkens, Lars G, Lohsiriwat, Visnu, Gulluoglu, Bahadir M, Karadeniz, Guldeniz, Karanlik, Hasan, Sezer, Atakan, Gulcelik, Mehmet Ali, Emiroglu, Mustafa, Kovacs, Tibor, Rattay, Tim, Romics, Laszlo, Vidya, Raghavan, Wyld, Lynda, El-Tamer, Mahmoud, Sacchini, Virgilio, Weber, Walter P, Morrow, Monica, Boniface, Jana de, Pusic, Andrea, Montagna, Giacomo, Kappos, Elisabeth A, Ritter, Mathilde, Haug, Martin, Kurzeder, Christian, Saccilotto, Ramon, Schulz, Alexandra, Benson, John, Fitzal, Florian, Matrai, Zoltan, Shaw, Jane, Peeters, Marie-Jeanne Vrancken, Potter, Shelley, and Heil, Joerg

Published
2020
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19. The association of breast surgery ASPIRE: breast pain pathway rapid evaluation project – study protocol

Author

Hubbard, Thomas J. E., primary, Isaac, Anna T., additional, Cui, Alice, additional, Cutress, Ramsey I., additional, Dave, Rajiv, additional, Ellis, Katy, additional, Fields, Jo, additional, Halliday, Suzanne, additional, Hu, Jennifer, additional, Potter, Shelley, additional, Chagla, Leena, additional, Cox, Karina, additional, and Holcombe, Christopher, additional

Published
2024
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20. The MARECA (national study of management of breast cancer locoregional recurrence and oncological outcomes) study: protocol for a prospective, multicentre cohort study

Author

Hartup, Sue M., primary, Morgan, Jenna L., additional, Cheng, Vinton WT, additional, Barry, Peter A., additional, Copson, Ellen, additional, Cutress, Ramsey I., additional, Dave, Rajiv, additional, Elsberger, Beatrix, additional, Fairbrother, Patricia, additional, Hogan, Brian, additional, Horgan, Kieran, additional, Kirwan, Cliona C., additional, McIntosh, Stuart A., additional, O’Connell, Rachel L., additional, Patani, Neill, additional, Potter, Shelley, additional, Rattay, Tim, additional, Sheehan, Lisa, additional, Wyld, Lynda, additional, and Kim, Baek, additional

Published
2024
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21. Overall survival after mastectomy versus breast-conserving surgery with adjuvant radiotherapy for early-stage breast cancer: meta-analysis.

Author

Rajan, Kiran K, Fairhurst, Katherine, Birkbeck, Beth, Novintan, Shonnelly, Wilson, Rebecca, Savović, Jelena, Holcombe, Chris, and Potter, Shelley

Subjects
LUMPECTOMY, RADIOTHERAPY, BREAST cancer, MASTECTOMY, OVERALL survival, NEOADJUVANT chemotherapy
Abstract

Background Breast-conserving surgery with adjuvant radiotherapy and mastectomy are currently offered as equivalent surgical options for early-stage breast cancer based on RCTs from the 1970s and 1980s. However, the treatment of breast cancer has evolved and recent observational studies suggest a survival advantage for breast-conserving surgery with adjuvant radiotherapy. A systematic review and meta-analysis was undertaken to summarize the contemporary evidence regarding survival after breast-conserving surgery with adjuvant radiotherapy versus mastectomy for women with early-stage breast cancer. Methods A systematic search of MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), and Embase that identified studies published between 1 January 2000 and 18 December 2023 comparing overall survival after breast-conserving surgery with adjuvant radiotherapy versus mastectomy for patients with unilateral stage 1–3 breast cancer was undertaken. The main exclusion criteria were studies evaluating neoadjuvant chemotherapy, rare breast cancer subtypes, and specific breast cancer populations. The ROBINS-I tool was used to assess risk of bias, with the overall certainty of evidence assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool. Studies without critical risk of bias were included in a quantitative meta-analysis. Results From 11 750 abstracts, 108 eligible articles were identified, with one article including two studies; 29 studies were excluded from the meta-analysis due to an overall critical risk of bias, 42 studies were excluded due to overlapping study populations, and three studies were excluded due to reporting incompatible results. A total of 35 observational studies reported survival outcomes for 909 077 patients (362 390 patients undergoing mastectomy and 546 687 patients undergoing breast-conserving surgery with adjuvant radiotherapy). The pooled HR was 0.72 (95% c.i. 0.68 to 0.75, P < 0.001), demonstrating improved overall survival for patients undergoing breast-conserving surgery with adjuvant radiotherapy. The overall certainty of the evidence was very low. Conclusion This meta-analysis provides evidence suggesting a survival advantage for women undergoing breast-conserving surgery with adjuvant radiotherapy for early-stage breast cancer compared with mastectomy. Although these results should be interpreted with caution, they should be shared with patients to support informed surgical decision-making. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Understanding decision-making for and against oncoplastic breast-conserving surgery as an alternative to a mastectomy in early breast cancer: UK ANTHEM qualitative study.

Author

Davies, Charlotte, Conefrey, Carmel, Mills, Nicola, Fairbrother, Patricia, Holcombe, Chris, Whisker, Lisa, Skillman, Joanna, White, Paul, MacMillan, Douglas, Comins, Charles, Hollingworth, William, and Potter, Shelley

Subjects
MAMMAPLASTY, LUMPECTOMY, MASTECTOMY, BREAST cancer, DECISION making, QUALITATIVE research
Abstract

Background: Oncoplastic breast-conserving surgery may allow women with early breast cancer to avoid a mastectomy, but many women undergo more extensive surgery, even when breast-conserving options are offered. The aim of the ANTHEM qualitative study was to explore factors influencing women's surgical decision-making for and against oncoplastic breast-conserving surgery. Methods: Semi-structured interviews were conducted with a purposive sample of women who had received either oncoplastic breast-conserving surgery or a mastectomy with or without immediate breast reconstruction to explore their rationale for procedure choice. Interviews were transcribed verbatim and analysed thematically. Trial registration number: ISRCTN18238549. Results: A total of 27 women from 12 centres were interviewed. Out of these, 12 had chosen oncoplastic breast-conserving surgery and 15 had chosen a mastectomy with or without immediate breast reconstruction. Overwhelmingly, women's decisions were guided by their surgical teams. Decision-making for and against oncoplastic breast-conserving surgery was influenced by three key inter-related factors: perceptions of oncological safety; the importance of maintaining/restoring femininity and body image; and practical issues. Oncological safety was paramount. Women who reported feeling reassured that oncoplastic breast-conserving surgery was oncologically safe were happy to choose this option. Those who were not reassured were more likely to opt for a mastectomy, as a perceived 'safer' option. Most women wished to maintain/restore femininity, with the offer of immediate breast reconstruction essential to make a mastectomy an acceptable option. Practical issues such as the perceived magnitude of the surgery were a lesser concern. Conclusion: Decision-making is complex and heavily influenced by the surgical team. High-quality, accurate information about surgical options, including appropriate reassurance about the short- and long-term oncological safety of oncoplastic breast-conserving surgery is vital if women are to make fully informed decisions. Perceived overestimation of the oncological benefits of a mastectomy and a lack of awareness of the potential short- and long-term issues associated with breast reconstruction raise concerns about the quality of the information provided to women making decisions about their options and the degree to which their decisions are fully informed. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Short-term safety outcomes of mastectomy and immediate implant-based breast reconstruction with and without mesh (iBRA): a multicentre, prospective cohort study

Author

Achuthan, R, Adwan, I, Aggarwal, S, Ahmed, M, Akelund, M, Akolekar, D, Al-Jibury, O, Amanita, M, Appleton, D, Archampong, D, Asgiersson, K, Athwal, R, Augusti, A, Ayaani, S, Bains, S, Baker, B, Baker, E, Baldota, S, Banerjee, D, Barker, S, Barr, L, Barry, P, Basu, N, Bathla, S, Bishop, N, Boland, G, Branford, O A, Bright-Thomas, R, Brindle, R, Brock, L, Brown, V, Bux, F, Byrne, G, Cain, H, Caldon, L, Callaghan, M, Carbone, A, Carpenter, R, Cawthorn, S, Chagla, L, Challoner, T, Chalmers, C, Chalmers, R, Chambers, S, Chana, M, Chand, N, Chandran, V, Chandrashekar, M, Charfare, H, Chatterjee, J, Chatterjee, S, Chattopadhyay, R, Chaudry, A, Chin, K, Chong, K, Chouhan, A, Choy, C, Christopoulos, P, Clarke, D, Clarke, S, Clayton, E, Clifford, R, Cocker, D, Collin, T, Collis, N, Conroy, F, Constantinou, C, Conway, A, Cook, J, Coombs, N, Cox, K, Critchley, A, Dakka, M, Dani, M, Daoud, R, Darragh, L, Darvesh, S, Dash, I, Datta, S, Davies, E, Dawson, S, De Sousa, E, Debnath, D, Deol, H, Devalia, H, Di Micco, R, Dicks, JR, Dickson, J, Dobner, N, Dobson, G, Dunne, N, Egbeare, D, El Sharief, D, Elfadl, D, Eltigani, E, Enver, D, Erel, E, Evans, A, Exarchos, G, Fage, E, Fatayer, H, Fenn, C, Ferguson, D, Foulkes, R, Franks, J, Fung, V, Galea, M, Gandamihardja, T, Gandhi, A, Garnsey, C, Gateley, C, Gattuso, J, Gawne, S, Geerthan, N, Ghattura, A, Giaramadze, A, Gill, J, Godden, AR, Goh, S, Govindarajulu, S, Goyal, S, Graja, T, Granger, S, Green, M, Grover, K, Gui, G, Gurung, R, Gutteridge, E, Hakim, A, Halka, A, Hamilton-Burke, W, Hamo, I, Harding-Mackean, C, Hargreaves, A, Harries, S, Harris, K, Harris, P, Harrison, S, Harvey, J, Hashem, M, Hassan, U, Henderson, J, Henton, J, Hignett, S, Hodgkins, K, Horgan, K, Horn, S, Hu, J, Hussain, A, Iddon, J, Iqbal, A, Irri, R, Irvine, T, Irwin, G, Iskender, A, Ismail, A, Ives, C, James, K, James, R, Jiwa, N, Jobson, M, Joglekar, S, Johnson, L, Johnson, R, Jones, L, Ju Hwang, M, Kalles, V, Kanesalingam, K, Karat, I, Kaushik, M, Kennedy, K, Khalifa, E, Khan, H, Khanbhai, M, Khawaja, S, Khout, H, Kiernan, T, Kim, B, Kirkpatrick, K, Kiruparan, P, Kirwan, C, Kishore, M, Kneeshaw, P, Knight, A, Kohlhardt, S, Krupa, J, Krupa, K, Kuruvilla, R, Laban, C, Lai, LM, Laidlaw, I, Lambert, K, Langlands, F, Lansdown, M, Laurence, N, Laws, S, Ledwidge, S, Lefemine, V, Lennon, H, Linforth, R, Little, K, Luangsomboon, A, Lund, J, Maalo, J, MacLennan, L, Macmillan, RD, MacNeil, F, Mahapatra, TK, Mallidis, E, Mallon, P, Manoloudakis, N, Maraqa, L, Marla, S, Masood, S, Massey, J, Masudi, T, Matey, P, Mazari, F, McCulley, S, McEvoy, K, Mcintosh, J, McIntosh, S, McKenzie, S, McManus, P, McNicholas, J, Michalakis, I, Mills, N, Mitchell, G, Monib, S, Mullan, M, Murphy, C, Murphy, G, Murphy, J, Murthy, B, Musa, S, Nagra, G, Nangalia, R, Narayanan, S, Nasr, R, Navin, C, Newton, R, Nicholson, S, Nuru, N, O'Connell, R, O'Donoghue, J, Ogedegbe, A, Olayinka, OS, Olsen, S, Osborn, G, Osborne, C, Osman, H, Otieno, C, Pakzad, F, Park, A, Parker, S, Partlett, P, Parvaiz, A, Parvanta, L, Patel, G, Peel, A, Peiris, L, Pennick, M, Peppe, A, Perry, D, Pilgrim, S, Piper, J, Poonawalla, S, Popa, E, Pope, V, Pugh, P, Rainsbury, D, Ramsey, K, Rasheed, T, Rathinaezhil, R, Rattay, T, Ravichandran, D, Reed, M, Refsum, S, Remoundos, D, Rigby, K, Robertson, S, Robinson, A, Robinson, J, Roche, N, Roy, PJ, Runkel, M, Rusby, J, Saha, S, Saidan, Z, Salab, M, Saleh, M, Salem, F, Sami, A, Samlalsingh, S, Sarfraz, N, Shah, R, Shaheed, S, Sharaiha, Y, Shetty, G, Shotton, R, Sircar, T, Skene, E, Sloan, S, Smith, B, Smith, J, Soldanova, L, Soliman, F, Soumian, S, Stevens, J, Steventon, C, Stewart-Parker, E, Stringfellow, T, Sutaria, R, Sutton, R, Sweetland, H, Swiech, B, Tadiparthi, S, Tafazal, H, Taheri, N, Tait, C, Tan, M, Tang, S, Tansley, A, Tate, S, Tayeh, S, Taylor, A, Taylor, J, Thawdar, P, Thomas, C, Thomas, S, Thomson, S, Thorne, A, Tillett, R, Tolkien, Z, Tomlins, A, Topps, A, Tsang, F, Turner, EJ, Turton, P, Udayasankar, S, Ugolini, F, Vaughan Williams, E, Vidya, R, Vijaynagar, B, Vinayagam, R, Volleamere, A, Voynov, V, Waheed, S, Walker, T, Walsh, U, Warner, R, Waters, R, Wilkins, A, Williams, K, Wilson, G, Wiltsher, M, Wooler, B, Wright, C, Wright, M, Wyld, L, Youssef, M, Zabkiewicz, C, Zammit, C, Zeidan, B, Zheng, D, Potter, Shelley, Conroy, Elizabeth J, Cutress, Ramsey I, Williamson, Paula R, Whisker, Lisa, Thrush, Steven, Skillman, Joanna, Barnes, Nicola L P, Mylvaganam, Senthurun, Teasdale, Elisabeth, Jain, Abhilash, Gardiner, Matthew D, Blazeby, Jane M, and Holcombe, Chris

Published
2019
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24. Opportunities and priorities for breast surgical research

Author

Basu, Narendra N, Benson, John R, Bundred, Nigel J, Carmichael, Amtul R, Coombs, Nathan, Cutress, Ramsey I, Dickson, John, Dixon, J Michael, Douek, Michael, Fairbrother, Patricia, Francis, Adele, Goyal, Amit, Harcourt, Diana, Harvey, James, Holcombe, Chris, Horsnell, Jonathan, Iqbal, Fahad M, Khan, Lucy R, Kirwan, Cliona C, Leff, Daniel R, Maxwell, Anthony J, McIntosh, Stuart A, Paraskeva, Nicole, Potter, Shelley, Rattay, Tim, Reed, Malcolm WR, Sami, Amtul S, Singer, Julian, St John, Edward R, Subramanian, Ash, Tobias, Jeffrey S, Touqan, Nader, Vaidya, Jayant S, Vidya, Raghavan, Winters, Zoe E, and Reed, Malcolm W R

Published
2018
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26. Investigating the feasibility of randomised clinical trials in breast reconstruction

Author

Potter, Shelley

Subjects
618.19059
Abstract

Breast cancer affects one in eight women and approximately 40% will require a mastectomy. The loss of a breast may dramatically impact upon quality of life. Breast reconstruction (BR) is offered to improve outcomes. Making decisions regarding BR surgery, however, is challenging and women and healthcare professionals (HCPs) need to weigh-up the likely benefits of surgery against the risks of adverse outcomes. Decisions are informed by published outcomes and surgeon and patient preferences. Well-designed studies, such as multi-centre randomised controlled trials (RCTs) provide the optimal evidence, but few RCTs have been undertaken in BR. The aim of this thesis was therefore to explore the need for and the feasibility of RCTs in BR. Three systematic literature reviews (SRs) critically appraised and summarised the quality of outcome reporting in BR and semi-structured qualitative interviews were conducted with women and HCPs to explore decision-making and attitudes to randomisation in BR. The clinical outcomes SR included 123 observational studies and 11 RCTs. The majority were at high-risk of bias and outcome reporting was heterogeneous. The cosmetic outcome SR included 122 studies. Cosmesis was assessed by patients and HCPs, but the methodology was inconsistent. The patient-reported outcome SR included 62 studies, less than 60% of which were considered methodologically robust. Sixty-two interviews with women and HCPs demonstrated decision-making in BR to be complex. A third of women reported decisional regret and insufficient time and information were identified as barriers to decision-making. Inequalities in access to care, however, emerged as the most significant determinant of women's reconstructive experience. Both women and HCPs accepted RCTs in BR in particular circumstances. There is an urgent need for well-designed studies with standardised outcome assessment in BR. Selected randomised trials may be feasible, but they are unlikely to address the key questions in BR. Service re-organisation and interventions to improve decision-making are needed to improve outcome for women considering BR in the UK.

Published
2011

28. Long-term patient-reported outcomes of immediate breast reconstruction after mastectomy for breast cancer: population-based cohort study

Author

Johnson, Leigh, primary, White, Paul, additional, Jeevan, Ranjeet, additional, Browne, John, additional, Gulliver-Clarke, Carmel, additional, O’Donoghue, Joe, additional, Mohiuddin, Syed, additional, Hollingworth, William, additional, Fairbrother, Patricia, additional, MacKenzie, Mairead, additional, Holcombe, Chris, additional, and Potter, Shelley, additional

Published
2023
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30. Variation in the provision and practice of implant-based breast reconstruction in the UK: Results from the iBRA national practice questionnaire

Author

Barnes, N.L.P., Blazeby, J.M., Branford, O.A., Conroy, E.J., Cutress, R.I., Gardiner, M.D., Holcombe, C., Jain, A., McEvoy, K., Mills, N., Mylvaganam, S., Potter, S., Skillman, J.M., Teasdale, E.M., Thrush, S., Whisker, L.J., Williamson, P.R., Tang, L., Nguyen, D., Johnson, R., Muralikrishnan, V., Chopra, S., Reid, A., Benyon, S., Murphy, C., Soliman, F., Lefemine, V., Saha, S., Ogedegbe, K., Olyinka, O.S., Dicks, J.R., Manoloudakis, N., Conroy, F., Irwin, G., McIntosh, S., Michalakis, I., Hignett, S., Linforth, R., Rathinaezhil, R., Osman, H., Anesti, K., Griffiths, M., Jacklin, R., Waterworth, A., Foulkes, R., Davies, E., Bisarya, K., Allan, A., Leon-Villapalos, J., Mazari, F.A.K., Azmy, I., George, S., Fahmy, F.S., Hargreaves, A., Seward, J., Henton, J., Collin, T., Mallon, P., Turner, J., Sarakbi, W., Athanasiou, I., Rogers, C., Youssef, M., Graja, T., Huf, S., Deol, H., Brindle, R., Gawne, S., Egbeare, D., Dash, I., Galea, M., Laws, S., Tayeh, S., Parvanta, L., Down, S., Westbroek, D., Roberts, J.W., Massey, J., Turton, P., Achuthan, R., Fawzy, M., Dickson, M., Carmichael, A.R., Akingboye, A., James, R., Kirkpatrick, K., Nael, E., Vidya, R., Thorne, A., Rostom, M., Depasquale, I., Cawthorn, S.J., Gangamihardja, T., Joglekar, S., Smith, J., Halka, A., MacMillan, D., Clark, S., Pearce, B., Mansfield, L., King, I., Hazari, A., Smith, B., Volleamere, A.J., Ferguson, D., Barnes, N., Knight, A., MacNeill, F., Conway, A., Irvine, T., Mylavaganam, S., Dunne, N., Kohlhardt, S., Hoo, C., Kirk, S., Hu, J., Ledwidge, S., Tang, S., Banerjee, D., Waheed, S., Voynov, V., Soumian, S., Henderson, J., Harvey, J., Robertson, S., Waters, R., Carbone, A., Skillman, J., Farooq, Ansar, Tafazal, H., Clarke, D., Cocker, D., Lai, L.M., Winter Beatty, J., Barkeji, M., Vinayagam, R., Mullan, M., Osborne, C., Baker, E., Piper, J., Mylvaganam, Senthurun, Conroy, Elizabeth, Williamson, Paula R., Barnes, Nicola L.P., Cutress, Ramsey I., Gardiner, Matthew D., Jain, Abhilash, Skillman, Joanna M., Thrush, Steven, Whisker, Lisa J., Blazeby, Jane M., Potter, Shelley, and Holcombe, Christopher

Published
2017
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34. The TeaM (Therapeutic Mammaplasty) study: Protocol for a prospective multi-centre cohort study to evaluate the practice and outcomes of therapeutic mammaplasty

Author

Baker, Elizabeth, Kim, Baek, Rattay, Tim, Williams, Kathryn, Ives, Charlotte, Remoundos, Dennis, Holcombe, Chris, Gardiner, Matthew D., Jain, Abhilash, Sutton, Richard, Achuthan, Rajgopal, Turton, Philip, Fairbrother, Patricia, Brock, Lisa, Aggarwal, Shweta, Basu, Naren, Murphy, John, Trickey, Adam, Macmillan, R. Douglas, and Potter, Shelley

Published
2016
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35. Correction: Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Author

Dave, Rajiv V., Kim, Baek, Courtney, Alona, O’Connell, Rachel, Rattay, Tim, Taxiarchi, Vicky P., Kirkham, Jamie J., Camacho, Elizabeth M., Fairbrother, Patricia, Sharma, Nisha, Cartlidge, Christopher W. J., Horgan, Kieran, McIntosh, Stuart A., Leff, Daniel R., Vidya, Raghavan, Potter, Shelley, Holcombe, Chris, Copson, Ellen, Coles, Charlotte E., Cutress, Ramsey I., Gandhi, Ashu, and Kirwan, Cliona C.

Published
2021
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37. Localization Techniques for Non-Palpable Breast Lesions : Current Status, Knowledge Gaps, and Rationale for the MELODY Study (EUBREAST-4/iBRA-NET, NCT 05559411)

Author

Banys-Paluchowski, Maggie, Kühn, Thorsten, Masannat, Yazan, Rubio, Isabel, de Boniface, Jana, Ditsch, Nina, Karadeniz Cakmak, Güldeniz, Karakatsanis, Andreas, Dave, Rajiv, Hahn, Markus, Potter, Shelley, Kothari, Ashutosh, Gentilini, Oreste Davide, Gulluoglu, Bahadir M., Lux, Michael Patrick, Smidt, Marjolein, Weber, Walter Paul, Aktas Sezen, Bilge, Krawczyk, Natalia, Hartmann, Steffi, Di Micco, Rosa, Nietz, Sarah, Malherbe, Francois, Cabioglu, Neslihan, Canturk, Nuh Zafer, Gasparri, Maria Luisa, Murawa, Dawid, Harvey, James, Banys-Paluchowski, Maggie, Kühn, Thorsten, Masannat, Yazan, Rubio, Isabel, de Boniface, Jana, Ditsch, Nina, Karadeniz Cakmak, Güldeniz, Karakatsanis, Andreas, Dave, Rajiv, Hahn, Markus, Potter, Shelley, Kothari, Ashutosh, Gentilini, Oreste Davide, Gulluoglu, Bahadir M., Lux, Michael Patrick, Smidt, Marjolein, Weber, Walter Paul, Aktas Sezen, Bilge, Krawczyk, Natalia, Hartmann, Steffi, Di Micco, Rosa, Nietz, Sarah, Malherbe, Francois, Cabioglu, Neslihan, Canturk, Nuh Zafer, Gasparri, Maria Luisa, Murawa, Dawid, and Harvey, James

Abstract

Background: Surgical excision of a non-palpable breast lesion requires a localization step. Among available techniques, wire-guided localization (WGL) is most commonly used. Other techniques (radioactive, magnetic, radar or radiofrequency-based, and intraoperative ultrasound) have been developed in the last two decades with the aim of improving outcomes and logistics. Methods: We performed a systematic review on localization techniques for non-palpable breast cancer. Results: For most techniques, oncological outcomes such as lesion identification and clear margin rate seem either comparable with or better than for WGL, but evidence is limited to small cohort studies for some of the devices. Intraoperative ultrasound is associated with significantly higher negative margin rates in meta-analyses of randomized clinical trials (RCTs). Radioactive techniques were studied in several RCTs and are non-inferior to WGL. Smaller studies show higher patient preference towards wire-free localization, but little is known about surgeons’ and radiologists’ attitudes towards these techniques. Conclusions: Large studies with an additional focus on patient, surgeon, and radiologist preference are necessary. This review aims to present the rationale for the MELODY (NCT05559411) study and to enable standardization of outcome measures for future studies. Simple summary Most breast cancers are small and can be treated using breast-conserving surgery. Since these tumors are non-palpable, they require a localization step that helps the surgeon to decide which tissue needs to be removed. The oldest localization technique is a guidewire placed into the tumor before surgery, usually using ultrasound or mammography. Afterwards, the surgeon removes the tissue around the wire tip. However, this technique has several disadvantages: It can cause the patient discomfort, requires a radiologist or another professional specialized in breast diagnostics to perform the procedure shortly before surgery, a

Published
2023
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38. Wire- and radiofrequency identification tag-guided localization of impalpable breast lesions: iBRA-NET localization study.

Author

Harvey, James, Morgan, Jenna, Lowes, Simon, Milligan, Robert, Barrett, Emma, Carmichael, Amtul, Elgammal, Suzanne, Masudi, Tahir, Holcombe, Chris, Masannat, Yazan, Potter, Shelley, Dave, Rajiv V, Al Numani, H, Kastora, S, Simpson, L, Lynch, R, Kleidi, E, Wignarajah, P, Johnson, L, and Ledwidge, S

Subjects
RADIO frequency
Abstract

A national cohort ideal stage 2a/2b study comparing the safety and effectiveness of Wire- and RFID -guided localisation for impalpable breast lesions. [ABSTRACT FROM AUTHOR]

Published
2024
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47. Abstract OT3-20-02: SMALL: Open Surgery versus Minimally invasive vacuum-Assisted excision for smaLL screen-detected breast cancer – a UK phase III randomised multi-centre trial

Author

McIntosh, Stuart A., primary, Coles, Charlotte E., additional, Dodwell, David, additional, Elder, Kenneth, additional, Foster, Jessica, additional, Gaunt, Claire, additional, Kirkham, Amanda, additional, Lyburn, Iain, additional, Morgan, Jenna, additional, Paramasivan, Sangeetha, additional, Pinder, Sarah E., additional, Pirrie, Sarah, additional, Potter, Shelley, additional, Roberts, Tracy, additional, Sharma, Nisha, additional, Stobart, Hilary, additional, Southgate, Elizabeth, additional, Taylor-Phillips, Sian, additional, Wallis, Matthew, additional, and Rea, Daniel, additional

Published
2023
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48. Abstract P6-05-17: Recruitment challenges in a UK surgical de-escalation study: preliminary qualitative research findings from the SMALL trial

Author

McIntosh, Stuart A., primary, Coles, Charlotte E., additional, Dodwell, David, additional, Elder, Kenneth, additional, Foster, Jessica, additional, Gaunt, Claire, additional, Kirkham, Amanda, additional, Lyburn, Iain, additional, Morgan, Jenna, additional, Pinder, Sarah E., additional, Pirrie, Sarah, additional, Potter, Shelley, additional, Roberts, Tracy, additional, Sharma, Nisha, additional, Stobart, Hilary, additional, Southgate, Elizabeth, additional, Taylor-Phillips, Sian, additional, Wallis, Matthew, additional, Rea, Daniel, additional, and Paramasivan, Sangeetha, additional

Published
2023
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49. Abstract PD15-10: PD15-10 Impact of procedure type on long-term revisional surgery and secondary reconstruction following immediate breast reconstruction: The UK Brighter national population-based cohort study

Author

Johnson, Leigh, primary, White, Paul, additional, Jeevan, Ranjeet, additional, Browne, John, additional, Gulliver-Clarke, Carmel, additional, O’Donoghue, Joe, additional, Mohiuddin, Syed, additional, Hollingworth, William, additional, Fairbrother, Patricia, additional, MacKenzie, Mairead, additional, Holcombe, Chris, additional, and Potter, Shelley, additional

Published
2023
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