“Deborah agreed to take part in a trial as she was keen to help other cancer patients in the future. "If taking part in a trial means others might be helped then I’m very happy with that."
A trial looking at quality of life after having immediate or delayed breast reconstruction surgery (QUEST B)
This trial looked at how women feel about the timing of surgery to make a new breast shape (breast reconstruction). The trial was supported by Cancer Research UK.
If you have surgery to remove breast cancer, you may have your whole breast removed. This is called a mastectomy. You can also have surgery to make a new breast shape. This is called breast reconstruction.
This trial was looking at the timing of one of the most common types of breast reconstruction that creates a new breast shape using muscle from your back and tissue from under your shoulder blade. It is called latissimus dorsi breast reconstruction (LDBR).
You can have LDBR breast reconstruction either at the same time as your mastectomy (immediate reconstruction). Or you can have it later on, normally after you have finished other breast cancer treatments. This is called stage delayed reconstruction.
You usually have stage delayed reconstruction in 2 parts. The first part is during your mastectomy, where the surgeon puts a temporary implant under your breast skin, to stretch the skin. You later have further surgery to create a new breast shape.
The researchers already knew that both immediate and stage delayed reconstruction gave good cosmetic results. But they wanted to find out if the different timings of surgery affected women’s quality of life.
This was a pilot study to see if it would be possible to run a larger trial. The main aim was to see how many women were willing to take part in a trial comparing the 2 different timings of surgery. The trial team also wanted to understand more about how women decided whether or not to take part.
Summary of results
The researchers found that it wasn’t possible to recruit enough women to run a larger trial. They did learn more about the reasons why women decided whether to take part or not.
This was a randomised trial. Women who agreed to take part were put into 1 of 2 groups by a computer. Neither they nor their doctor could decide which group they were in.
During the 18 months that the trial was open to recruitment, the team asked 36 women to take part and 8 of them (22%) agreed to be randomised.
- 4 had immediate breast reconstruction
- 4 had stage delayed reconstruction
As only a small number of women took part, the trial team hasn’t produced results about any differences in quality of life after the 2 different timings of reconstruction surgery.
Researchers who were not part of the clinical care team asked women to fill in questionnaires asking what they thought about the trial. They asked women who had agreed to take part in QUEST B and women who had decided not to.
They wanted to find out what women thought about being asked to take part and why they agreed to do so, or not. They found the main reason women decided not to take part was because they had a preference about the timing of their surgery and didn’t want this to be decided by a computer.
The researchers had worked out that they would need 25% of eligible women to take part if they were going to run a larger trial. In this pilot study, only 22% of eligible women agreed to take part. So they are not planning to do a larger trial.
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Dr Zoe Winters
Cancer Research UK
Centre for Behavioural Medicine (University of London)
Institute of Cancer Research (ICR)
NIHR Clinical Research Network: Cancer
University Hospitals Bristol NHS Foundation Trust
This is Cancer Research UK trial number CRUK/08/027.