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Is implant placement under or above the chest muscle best in immediate breast reconstruction?

Is subpectoral or pre-pectoral implant placement Best in immediate BReAst reconstruction? The Best-BRA Pilot Trial

Status
Active, not recruiting
Phases
Unknown
Study type
Interventional
Source
ISRCTN
Registry ID
ISRCTN10081873
Enrollment
100
Registered
2021-01-12
Start date
2021-07-26
Completion date
Unknown
Last updated
2025-09-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Implant-based breast reconstruction following mastectomy for breast cancer or risk reduction Surgery

Interventions

Women who require a mastectomy for either breast cancer or risk reduction and elect to have an IBRR will be recruited and randomised 1:1 for either a subpectoral or pre-pectoral implant reconstruction

Sponsors

North Bristol NHS Trust
Lead Sponsor

Eligibility

Sex/Gender
Female

Inclusion criteria

Inclusion criteria: 1. Aged 18 years or above 2. Require a mastectomy for breast cancer or risk-reduction 3. Elect to undergo immediate IBBR 4. Considered eligible for either pre or subpectoral reconstruction by the surgical team

Exclusion criteria

Exclusion criteria: 1. Had a delayed reconstruction 2. Has had revision breast reconstruction surgery

Design outcomes

Primary

MeasureTime frame
Assessed throughout the duration of the trial using screening logs: 1. Recruitment into trial (number of sites recruiting; proportion of eligible women approached that are randomised, women recruited per site per month) 2. Adherence to trial allocation by comparing number of women allocated to trial intervention vs. their actual reconstruction (i.e pre-pec or subpectoral IBBR) 3. Completion rates measured by overall data completeness (% missing data)

Secondary

MeasureTime frame
1. Satisfaction with breasts using the validated BREAST-Q questionnaire at 12 months 2. Surgical complications, in particular implant loss, infection, re-admission and reoperation measured using patient records at 3 and 12 months 3. Need for additional surgery to the reconstruction or the contralateral breast measured using patient records at 12 months 4. Pain scores assessed using a visual analogue scale (VAS) at 24 hours and 1 week 5. Objective cosmetic outcome at 12 months assessed using routinely collected patient photographs 6. EQ-5D-5L health-related quality of life score at 12 months 7. Wellbeing (ICECAP-A) score at 12 months 8. Patient-reported outcome domains included in the breast reconstruction core outcome set including physical well-being (chest); emotional well-being; and animation assessed using appropriate subscales of the BREAST-Q at 12 months 9. Cost-effectiveness of pre-pectoral and subpectoral IBBR assessed by micro-costing the two procedures. Data will be gathered from electronic notes/medical records as well as routine data

Countries

England, United Kingdom

Contacts

Public ContactKirsty Roberts
kirsty.roberts@bristol.ac.uk+44 (0)7989 981816

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 14, 2026