Variation in the provision and practice of implant-based breast reconstruction in the UK: results from the iBRA national practice questionnaire
Variation in the provision and practice of implant-based breast reconstruction in the UK: results from the iBRA national practice questionnaire
INTRODUCTION: The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore the practice and outcomes of IBBR to inform the design of a future trial. We report the results of the iBRA National Practice Questionnaire (NPQ) which aimed to comprehensively describe the provision and practice of IBBR across the UK.
METHODS: A questionnaire investigating local practice and service provision of IBBR developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Summary data for each survey item were calculated and variation between centres and overall provision of care examined.
RESULTS: 81 units within 79 NHS-hospitals completed the questionnaire. Units offered a range of reconstructive techniques, with IBBR accounting for 70% (IQR:50-80%) of participating units' immediate procedures. Units on average were staffed by 2.5 breast surgeons (IQR:2.0-3.0) and 2.0 plastic surgeons (IQR:1.0-3.0) performing 35 IBBR cases per year (IQR:20-50). Variation was demonstrated in the provision of novel different techniques for IBBR especially the use of biological (n = 62) and synthetic (n = 25) meshes and in patient selection for these procedures.
CONCLUSIONS: The iBRA-NPQ has demonstrated marked variation in the provision and practice of IBBR in the UK. The prospective audit phase of the iBRA study will determine the safety and effectiveness of different approaches to IBBR and allow evidence-based best practice to be explored.
Journal Article
182-190
Mylvaganam, Senthurun
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Conroy, Elizabeth
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Williamson, Paula R
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Barnes, Nicola L P
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Cutress, Ramsey I
68ae4f86-e8cf-411f-a335-cdba51797406
Gardiner, Matthew D
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Jain, Abhilash
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Skillman, Joanna M
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Thrush, Steven
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Whisker, Lisa J
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Blazeby, Jane M
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Potter, Shelley
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Holcombe, Christopher
e10e54d6-3370-45be-a43f-59a381f4391c
October 2017
Mylvaganam, Senthurun
69d44b29-5c5f-4dd6-976a-8cee876196c8
Conroy, Elizabeth
b795ac6f-11d2-4197-b11c-3e85f56eead2
Williamson, Paula R
cef0b386-84e6-4f2e-8e9b-516c58a14e44
Barnes, Nicola L P
4ec5f15a-362a-459c-8b50-f6b15aa94081
Cutress, Ramsey I
68ae4f86-e8cf-411f-a335-cdba51797406
Gardiner, Matthew D
eea0ad25-65ea-4867-a60c-311aac543eab
Jain, Abhilash
c68ef4be-e2dd-4317-9d2e-f146a2ee9e4c
Skillman, Joanna M
9dcb124c-14c3-4f88-be59-5c802c573aad
Thrush, Steven
54ed886c-690c-41e8-a7d6-6bc05d4b7dd6
Whisker, Lisa J
6cae5575-e545-407f-9b9d-7a6db1f2cd42
Blazeby, Jane M
689d490e-fca3-4430-88de-f19ec6cebf58
Potter, Shelley
77970724-8e7c-47cb-973c-d5a7c6bd783c
Holcombe, Christopher
e10e54d6-3370-45be-a43f-59a381f4391c
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
,
iBRA Steering Group
(2017)
Variation in the provision and practice of implant-based breast reconstruction in the UK: results from the iBRA national practice questionnaire.
The Breast, 35, .
(doi:10.1016/j.breast.2017.07.016).
Abstract
INTRODUCTION: The introduction of biological and synthetic meshes has revolutionised the practice of implant-based breast reconstruction (IBBR) but evidence for effectiveness is lacking. The iBRA (implant Breast Reconstruction evAluation) study is a national trainee-led project that aims to explore the practice and outcomes of IBBR to inform the design of a future trial. We report the results of the iBRA National Practice Questionnaire (NPQ) which aimed to comprehensively describe the provision and practice of IBBR across the UK.
METHODS: A questionnaire investigating local practice and service provision of IBBR developed by the iBRA Steering Group was completed by trainee and consultant leads at breast and plastic surgical units across the UK. Summary data for each survey item were calculated and variation between centres and overall provision of care examined.
RESULTS: 81 units within 79 NHS-hospitals completed the questionnaire. Units offered a range of reconstructive techniques, with IBBR accounting for 70% (IQR:50-80%) of participating units' immediate procedures. Units on average were staffed by 2.5 breast surgeons (IQR:2.0-3.0) and 2.0 plastic surgeons (IQR:1.0-3.0) performing 35 IBBR cases per year (IQR:20-50). Variation was demonstrated in the provision of novel different techniques for IBBR especially the use of biological (n = 62) and synthetic (n = 25) meshes and in patient selection for these procedures.
CONCLUSIONS: The iBRA-NPQ has demonstrated marked variation in the provision and practice of IBBR in the UK. The prospective audit phase of the iBRA study will determine the safety and effectiveness of different approaches to IBBR and allow evidence-based best practice to be explored.
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Accepted/In Press date: 24 July 2017
e-pub ahead of print date: 30 July 2017
Published date: October 2017
Keywords:
Journal Article
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Local EPrints ID: 413149
URI: http://eprints.soton.ac.uk/id/eprint/413149
ISSN: 0960-9776
PURE UUID: 49201d64-30d2-4ee1-8e97-010810d08c77
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Date deposited: 16 Aug 2017 16:30
Last modified: 15 Mar 2024 15:37
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Contributors
Author:
Senthurun Mylvaganam
Author:
Elizabeth Conroy
Author:
Paula R Williamson
Author:
Nicola L P Barnes
Author:
Matthew D Gardiner
Author:
Abhilash Jain
Author:
Joanna M Skillman
Author:
Steven Thrush
Author:
Lisa J Whisker
Author:
Jane M Blazeby
Author:
Shelley Potter
Author:
Christopher Holcombe
Corporate Author: iBRA Steering Group
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