PMID- 36764040
OWN - NLM
STAT- MEDLINE
DCOM- 20230328
LR  - 20230331
IS  - 1878-0539 (Electronic)
IS  - 1748-6815 (Linking)
VI  - 78
DP  - 2023 Mar
TI  - Pre-operative Radiotherapy And Deep Inferior Epigastric Artery Perforator (DIEP) 
      flAp study (PRADA): Aesthetic outcome and patient satisfaction at one year.
PG  - 19-28
LID - S1748-6815(22)00672-6 [pii]
LID - 10.1016/j.bjps.2022.11.040 [doi]
AB  - INTRODUCTION: The optimal combination of radiotherapy and breast reconstruction 
      has not yet been defined. Post-mastectomy radiotherapy (PMRT) has deleterious 
      effects on breast reconstruction, leading to caution amongst surgeons. 
      Pre-operative radiotherapy (PRT) is a growing area of interest, is demonstrated 
      to be safe, and spares autologous flaps from radiotherapy. This study evaluates 
      the aesthetic outcome of PRT and deep inferior epigastric artery perforator 
      (DIEP) flap reconstruction within the Pre-operative Radiotherapy And Deep 
      Inferior Epigastric artery Perforator (DIEP) flAp (PRADA) cohort. METHODS: PRADA 
      was an observational cohort study designed to evaluate the feasibility and safety 
      of PRT for women undergoing neoadjuvant chemotherapy and DIEP reconstruction. 
      Panel evaluation of 3D surface images (3D-SIs) and patient-reported outcome 
      measures (BREAST-Q) for a subset of women in the study were compared with those 
      of a DIEP-PMRT cohort who had undergone DIEP reconstruction and PMRT. RESULTS: 
      Seventeen out of 33 women from the PRADA study participated in this planned 
      substudy. Twenty-eight women formed the DIEP-PMRT cohort (median follow-up 23 
      months). The median (inter-quartile range [IQR]) 'satisfaction with breasts' 
      score at 12 months for the PRADA cohort was significantly better than the 
      DIEP-PMRT cohort (77 [72-87] versus 64 [54-71], respectively), p=0.01). Median 
      [IQR] panel evaluation (5-point scale) was also significantly better for the 
      PRADA cohort than for the DIEP-PMRT cohort (4.3 [3.9-4.6] versus 3.6 [2.8-4] 
      p=0.003). CONCLUSIONS: Aesthetic outcome for the PRADA cohort was reported to be 
      'good' or 'excellent' in 93% of cases using a bespoke panel assessment with 
      robust methodology. Patient satisfaction at one year is encouraging and superior 
      to DIEP-PMRT at 23 months. Switching surgery-radiotherapy sequencing leads to 
      similar breast aesthetic outcomes and warrants further large-scale, multi-centre 
      evaluation in a randomised trial.
CI  - Copyright (c) 2023 British Association of Plastic, Reconstructive and Aesthetic 
      Surgeons. Published by Elsevier Ltd. All rights reserved.
FAU - Godden, Amy R
AU  - Godden AR
AD  - The Royal Marsden NHS Foundation Trust, United Kingdom; Institute of Cancer 
      Research, United Kingdom.
FAU - Micha, Aikaterini
AU  - Micha A
AD  - The Royal Marsden NHS Foundation Trust, United Kingdom.
FAU - O'Connell, Rachel L
AU  - O'Connell RL
AD  - The Royal Marsden NHS Foundation Trust, United Kingdom; Institute of Cancer 
      Research, United Kingdom.
FAU - Mohammed, Kabir
AU  - Mohammed K
AD  - The Royal Marsden NHS Foundation Trust, United Kingdom.
FAU - Kirby, Anna M
AU  - Kirby AM
AD  - The Royal Marsden NHS Foundation Trust, United Kingdom; Institute of Cancer 
      Research, United Kingdom.
FAU - Thiruchelvam, Paul T R
AU  - Thiruchelvam PTR
AD  - Imperial College Healthcare NHS Trust, London, United Kingdom.
FAU - Leff, Daniel R
AU  - Leff DR
AD  - Imperial College Healthcare NHS Trust, London, United Kingdom.
FAU - MacNeill, Fiona A
AU  - MacNeill FA
AD  - The Royal Marsden NHS Foundation Trust, United Kingdom.
FAU - Rusby, Jennifer E
AU  - Rusby JE
AD  - The Royal Marsden NHS Foundation Trust, United Kingdom; Institute of Cancer 
      Research, United Kingdom. Electronic address: Jennifer.rusby@rmh.nhs.uk.
CN  - PRADA Investigators
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20230120
PL  - Netherlands
TA  - J Plast Reconstr Aesthet Surg
JT  - Journal of plastic, reconstructive & aesthetic surgery : JPRAS
JID - 101264239
SB  - IM
MH  - Female
MH  - Humans
MH  - Patient Satisfaction
MH  - Mastectomy/methods
MH  - Epigastric Arteries/surgery
MH  - *Breast Neoplasms/radiotherapy/surgery
MH  - *Perforator Flap/blood supply
MH  - *Mammaplasty/methods
MH  - Esthetics
MH  - Retrospective Studies
OTO - NOTNLM
OT  - 3D-SI
OT  - Aesthetics
OT  - DIEP
OT  - Neoadjuvant radiotherapy
OT  - PROMs
OT  - Reconstruction
FIR - Cleator, Susan
IR  - Cleator S
FIR - Godden, Amy
IR  - Godden A
FIR - Gujral, Dorothy
IR  - Gujral D
FIR - Hadjiminas, Dimitri
IR  - Hadjiminas D
FIR - James, Stuart E
IR  - James SE
FIR - Khan, Aadil
IR  - Khan A
FIR - Kirby, Anna M
IR  - Kirby AM
FIR - Leff, Daniel R
IR  - Leff DR
FIR - MacNeill, Fiona A
IR  - MacNeill FA
FIR - Patani, Neill
IR  - Patani N
FIR - Ross, Gillian
IR  - Ross G
FIR - Rusby, Jennifer E
IR  - Rusby JE
FIR - Somaiah, Navita
IR  - Somaiah N
FIR - Thiruchelvam, Paul Tr
IR  - Thiruchelvam PT
FIR - Wood, Simon H
IR  - Wood SH
EDAT- 2023/02/11 06:00
MHDA- 2023/03/28 17:13
CRDT- 2023/02/10 18:04
PHST- 2022/06/13 00:00 [received]
PHST- 2022/10/03 00:00 [revised]
PHST- 2022/11/17 00:00 [accepted]
PHST- 2023/03/28 17:13 [medline]
PHST- 2023/02/11 06:00 [pubmed]
PHST- 2023/02/10 18:04 [entrez]
AID - S1748-6815(22)00672-6 [pii]
AID - 10.1016/j.bjps.2022.11.040 [doi]
PST - ppublish
SO  - J Plast Reconstr Aesthet Surg. 2023 Mar;78:19-28. doi: 
      10.1016/j.bjps.2022.11.040. Epub 2023 Jan 20.