A study looking at radiotherapy before surgery to remove breast cancer (PRADA)

Cancer type:

Breast cancer

Status:

Results

Phase:

Other

This study looked at having radiotherapy before surgery instead of having it after surgery for breast cancer. It was for women having surgery and a breast reconstruction Open a glossary item at the same time.

The study was open for women to join between 2015 and 2018. The team published the results in 2022.

More about this trial

Surgery is often the first treatment for breast cancer. There are other treatments including radiotherapy.

Some women have a breast reconstruction at the same time as surgery to remove the breast. One way to do this is to make a breast shape from the woman’s own body tissue. The women in this study all had their reconstruction done in this way.

Surgery to remove all of the breast is called a mastectomy. Some women need radiotherapy after surgery for breast cancer. This works well but sometimes having radiotherapy after surgery can cause some problems. It might:

damage the new breast tissue which can affect the breast shape and appearance in the longer term
delay radiotherapy if it takes longer to recover from surgery. This might mean radiotherapy doesn’t work as well.

Researchers thought it might be better to have radiotherapy before breast cancer surgery. They hoped this could improve quality of life Open a glossary item and mean women could spend less time having treatment. So they did this study to find out more.

The main aims of this feasibility study Open a glossary item were to:

see if having radiotherapy before a mastectomy and breast reconstruction causes any extra problems with wound healing
assess the appearance of the new breast

Summary of results

33 women took part in this study. They all had radiotherapy before surgery. This took about 3 weeks. They then had surgery 2 to 6 weeks after radiotherapy had finished.

The team assessed everyone’s breast wound 4 weeks after surgery. They looked at the number of people who had a wound that was bigger than 1cm across or needed a dressing to cover it. They found 4 people had an open wound that was larger than 1cm that needed a dressing.

This was similar to the reported number of open wounds in those who have radiotherapy after surgery.

Side effects
Radiotherapy can make the skin sore in the treatment area. This can affect wound healing. Most side effects that affected the skin in this study were mild to moderate.

1 person had a more severe skin side effect. This was blistering and peeling and the wound needed a dressing to cover it as it leaked fluid.

Conclusion
The study team found that it was safe and possible to have radiotherapy before surgery and a breast reconstruction.

This was a small study done in a few hospitals. The team say a larger trial needs to be done to find out more about having treatment in this order. This would compare having radiotherapy before surgery with having it in the usual way after surgery.

More detailed information
There is more information about this research in the reference below.

Please note, the information we link to here is not in plain English. It has been written for healthcare professionals and researchers.

Primary radiotherapy and deep inferior epigastric perforator flap reconstruction for patients with breast cancer (PRADA): a multicentre, prospective, non-randomised, feasibility study
P Thiruchelvam and others
Lancet Oncology, 2022. Volume 23, issue 5, pages 682–690

Where this information comes from
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.