Implant-based breast reconstruction (IBBR) is the most commonly used breast reconstruction procedure in the UK accounting for almost 70% of all immediate breast reconstructions carried out following a mastectomy. Implants are typically placed under the chest muscle (subpectoral) or placed on top of the chest muscle (pre-pectoral). Both are standard procedures commonly performed across the UK but currently there is no good evidence which implant procedure is best for patients.
The Best-BRA study will test whether subpectoral or pre-pectoral implant placement improves women’s satisfaction with the outcome of their reconstruction. However, first we need to find out if such a study is possible before we do a much larger definitive study. As there is insufficient evidence to say whether the implant would be better placed on top or underneath the chest muscle, we need to do a fair comparison of the different procedures. Women who decide to take part in the study will be divided into two equal groups using a process called randomisation. One group will have a subpectoral implant-based breast reconstruction (placing implant underneath the chest muscle) and the other will have a pre-pectoral implant-based breast reconstruction (placing implant on top of the chest muscle). Allocating implant procedure through randomisation will ensure that groups are similar and enable a fair comparison of the procedures. We also want to capture how information about the study is given to patients by recording consultations. This will help us understand how research studies are explained to people and if there are any improvements we can make.
The Best-BRA study is now closed.