“I had treatment last year and I want to give something back.”
A trial looking at quality of life after having a mastectomy and breast reconstruction (QUEST A)
This trial was comparing how women feel after having 1 of 2 types 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. You may have breast reconstruction at the same time as a mastectomy.
This trial was looking at one of the most common type 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).
There are 2 ways to carry out LDBR. The back flap method makes a new breast shape from muscle, fat and skin from your back. The implant assisted method uses the same muscle, but less fat and skin. Instead it uses a salt water or silicone implant to create the breast shape.
The researchers already knew that both methods gave good cosmetic results. But they wanted to find out how each method 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 types 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 88 women to take part and 17 of them (19%) agreed to be randomised.
- 9 had breast reconstruction surgery with the back flap method
- 8 had breast reconstruction surgery with implant assisted method
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 types of breast reconstruction.
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 A 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 in the trial was because they had a preference about the type of surgery they had 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 19% 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.