This study is now closed.

Each year, approximately 51,000 women will be diagnosed with breast cancer, of which up to 40% may require a mastectomy. This may impact on a woman’s quality of life and body image and, in the UK, immediate breast reconstruction (IBR) is routinely offered to improve outcomes.

Complication rates following immediate breast reconstruction may have a significant impact, as this may lead to the delay or omission of adjuvant chemo and/or radiotherapy. The clinical significance of these short delays remains unclear, but studies have demonstrated an adverse impact on recurrence free and overall survival. A 2013 meta-analysis suggests a 15% decrease in overall survival for every four week delay in the delivery of adjuvant chemotherapy.

iBRA-2 is a national multi centre prospective audit which aims to evaluate the impact of immediate breast reconstruction on the time to adjuvant therapy compared with mastectomy alone.




  • The aims of the study are to evaluate:
  • The rate of post-operative complications
  • The requirement of adjuvant chemotherapy / radiotherapy
  • Which patients experience of a delay to / or omission of their adjuvant therapy as a result of post-operative complications
  • The time to adjuvant therapyTo identify risk factors to identify patients who may experience a delay / or omission of adjuvant therapy due to post operative complications
  • Generate high quality data to inform patient and healthcare worker decision making

Inclusion criteria


All patients having a mastectomy for invasive cancer or DCIS with or without a breast reconstruction (of ANY type - implant-based, pedicle or free flap) have been included in the study. Patients having risk reducing surgery, and patients not having a total mastectomy have been excluded.